WO2024023739A1

WO2024023739A1 - Surgical suturing instruments

Info

Publication number: WO2024023739A1
Application number: PCT/IB2023/057596
Authority: WO
Inventors: Alexander D. NORMAN; Zhixu XING; Charles F. Kilby; Paul PEATSON; Richard O. Kuenzler; Brian A. Rockrohr; Eric J. Taylor; Alejandro Suarez
Original assignee: Covidien LP
Current assignee: Covidien LP
Priority date: 2022-07-29
Filing date: 2023-07-26
Publication date: 2024-02-01
Anticipated expiration: 2025-01-29
Also published as: EP4561458A1; CN119677471A

Abstract

A surgical suturing instrument includes first and second jaw members each defining a hole for detachable receipt of opposite ends of a curved needle. The first jaw member is pivotable relative to the second jaw member to move and transfer the curved needle between the jaw members. A set of cam members are operably coupled to one another to drive an opposing axial motion of a pair of needle retention blades.

Description

SURGICAL SUTURING INSTRUMENTS

INTRODUCTION

[0001] In many surgical procedures, including those involved in endoscopic surgery, it is often necessary to suture bodily organs or tissue. In the past, suturing of bodily organs or tissue through endoscopic surgery was achieved through the use of a sharp metal suture needle which had attached at one of its ends a length of suture material. The surgeon would cause the suture needle to penetrate and pass through bodily tissue, pulling the suture material through the bodily tissue. Once the suture material was pulled through the bodily tissue, the surgeon tied a knot in the suture material.

SUMMARY

[0002] In accordance with one aspect of the disclosure, a surgical suturing instrument is provided and includes a first jaw member, a second jaw member operably coupled to the first jaw member, an actuation bar configured to translate relative to the first and second jaw members to pivot the first and second jaw members between opened and closed configurations, a first needle retention blade movable within the first jaw member, a second needle retention blade movable within the second jaw member, and a cam member coupled to a distal end portion of the actuation bar and configured to rotate in a first rotational direction relative to the distal end portion of the actuation bar in response to a proximal or distal movement of the actuation bar. Each of the first and second needle retention blades has a proximal end portion coupled to the cam member such that the first and second needle retention blades are configured to translate in opposite directions in response to the rotation of the cam member in the first rotational direction.

[0003] In aspects, the cam member may be a barrel cam configured to rotate in the first rotational direction in response to the proximal movement of the actuation bar and also in response to the distal movement of the actuation bar.

[0004] In aspects, the distal end portion of actuation bar may include a cam member defining a pair of first and second cam slots configured to rotate the barrel cam in the first rotational direction relative to the cam member of the actuation bar. [0005] In aspects, the barrel cam may be configured to slidably receive the cam member of the actuation bar.

[0006] In aspects, the first cam slot may include a first portion configured to rotate the barrel cam in the first rotational direction during the distal movement of the actuation bar, and a second portion configured to rotate the barrel cam in the first rotational direction during the proximal movement of the actuation bar.

[0007] In aspects, the barrel cam may include first and second protrusions received in the respective first and second cam slots.

[0008] In aspects, the cam member of the actuation bar may define first and second linear channels extending proximally from the respective first and second cam slots. The barrel cam may be configured to maintain a rotational orientation thereof in response to distal or proximal movement of the actuation bar when the first and second protrusions of the barrel cam are received in the respective first and second linear channels.

[0009] In aspects, the first jaw member may include a proximal end portion defining a distal cam slot and a proximal guide slot extending proximally from the distal cam slot. The actuation bar may include a boss extending from the distal end portion of the actuation bar. The boss of the actuation bar may be configured to pivot the first jaw member during translation of the boss through the distal cam slot.

[0010] In aspects, the boss of the actuation bar may be configured to be received in the distal cam slot of the first jaw member when the first and second protrusions of the barrel cam are received in the respective first and second linear channels of the cam member of the actuation bar. The boss of the actuation bar may be configured to be received in the proximal guide slot of the first jaw member when the first and second protrusions of the barrel cam are received in the respective first and second cam slots of the cam member of the actuation bar.

[0011] In aspects, the barrel cam may define a cam slot, and each of the first and second needle retention blades may have a protrusion extending from the proximal end portion thereof and into the cam slot of the barrel cam. [0012] In aspects, the barrel cam may include a discrete slot in communication with the cam slot. The discrete slot may be configured to maintain an axial position of the first or second protrusion of one of the first or second needle retention blades when the barrel cam rotates in a second rotational direction, opposite the first rotational direction.

[0013] In aspects, each of the first and second needle retention blades may have a distal end portion configured to engage a respective end portion of a needle to selectively retain the needle with the first or second jaw members.

[0014] In accordance with another aspect of the disclosure, an end effector of a surgical suturing instrument includes a body portion, a first jaw member pivotably coupled to the body portion, first and second jaw members at least one of which being pivotably coupled to the body portion, first and second protuberances, first and second cam members, and first and second needle retention members. The first jaw member includes a proximal end portion defining a first cam slot, and a distal end portion defining a hole configured for detachable receipt of a first end of a needle. The second jaw member includes a proximal end portion defining a second cam slot, and a distal end portion defining a hole configured for detachable receipt of a second end of the needle. The first and second protuberances are received in the respective first and second cam slots and are configured to translate through the first and second cam slots to move the first and second jaw members relative to one another between opened and closed configurations. The first cam member is configured to translate relative to the body portion. The first cam member defines first and second cam slots and the second cam member defines a cam slot. The second cam member includes first and second protrusions received in the respective first and second cam slots of the first cam member such that the second cam member rotates relative to the first cam member as the first cam member translates relative to the body portion. The first and second needle retention members extend through the respective first and second jaw members and each includes a proximal end portion engaged with the cam slot of the second cam member such that the first and second needle retention members are configured to translate in opposite directions in response to the rotation of the second cam member.

[0015] In aspects, the end effector may further include an actuation bar including a proximal end portion, and a distal end portion. The distal end portion of the actuator bar includes the first cam member and the first and second protuberances such that the first cam member and the first and second protuberances translate together relative to the body portion as the actuation bar translates.

[0016] In aspects, the second cam member may be a barrel cam configured to rotate in a first rotational direction in response to each of a proximal movement of the actuation bar and a distal movement of the actuation bar.

[0017] In aspects, the barrel cam may be configured to slidably receive the first cam member.

[0018] In aspects, the first cam slot of the first cam member may include a first portion configured to rotate the barrel cam in the first rotational direction during the distal movement of the actuation bar, and a second portion configured to rotate the barrel cam in the first rotational direction during the proximal movement of the actuation bar.

[0019] In accordance with yet another aspect of the disclosure, an end effector of a robotic surgical system is provided and includes a body portion, first and second jaw members each coupled to the body portion, a first needle retention member slidably received within the first jaw member, a second needle retention member slidably received within the second jaw member, an elongated actuator, and a rotatable cam member coupled to a distal end portion of the elongated actuator. The distal end portion of the elongated actuator is operably coupled to at least one of the first or second jaw members to transition the first and second jaw members between an opened configuration and a closed configuration. The rotatable cam member is coupled to the distal end portion of the elongated actuator and configured to rotate in a first rotational direction (e.g., counter-clockwise when viewed in a proximal-to-distal direction) relative to the distal end portion of the elongated actuator in response to a proximal or distal movement of the distal end portion of the elongated actuator. Each of the first and second needle retention members includes a proximal end portion operably coupled to the rotatable cam member such that the first and second needle retention members are configured to translate in opposite directions in response to the rotation of the rotatable cam member. [0020] In aspects, the distal end portion of the elongated actuator may include a cam member configured for slidable receipt within the rotatable cam member. The cam member of the elongated actuator may define a pair of first and second cam slots and the rotatable cam member may include first and second protrusions configured for receipt in the respective first and second cam slots.

[0021] In aspects, the first jaw member may define a hole configured for detachable receipt of a first end of a needle and the second jaw member may define a hole configured for detachable receipt of a second end of the needle. The first and second needle retention members may each include a proximal end portion configured for receipt in a helical slot defined in the rotatable cam member, and a distal end portion configured to overlap with the respective holes of the first and second jaw members to selectively engage one of the first or second ends of the needle.

[0022] Further details and aspects of exemplary embodiments of the disclosure are described in more detail below with reference to the appended figures.

[0023] As used herein, the terms parallel and perpendicular are understood to include relative configurations that are substantially parallel and substantially perpendicular up to about + or - 10 degrees from true parallel and true perpendicular.

BRIEF DESCRIPTION OF THE DRAWINGS

[0024] The above and other objects and features of the disclosure will become apparent from the following description of embodiments given in conjunction with the accompanying drawings, in which:

[0025] FIG. 1 is a schematic illustration of a surgical robotic system including a control tower, a console, and one or more surgical robotic arms;

[0026] FIG. 2 is a perspective view illustrating a surgical suturing instrument for use with the surgical robotic system of FIG. 1 including an end effector and a needle exchange mechanism; [0027] FIG. 3 is a perspective view illustrating the end effector of the surgical suturing instrument of FIG. 2, with first and second jaw members thereof shown in an opened configuration;

[0028] FIG. 4 is a perspective view illustrating the end effector of FIG. 3, with the first and second jaw members thereof shown in a closed configuration;

[0029] FIG. 5 is a perspective view illustrating the end effector of FIG. 3, with the jaw members thereof shown in phantom and a body portion thereof removed, showing first and second retention blades in respective distal and proximal position;

[0030] FIG. 6 is a perspective view illustrating the end effector of FIG. 4, with the jaw members thereof shown in phantom and the body portion thereof removed, showing the first and second retention blades in respective proximal and distal positions;

[0031] FIG. 7 is a perspective view illustrating a first cam member and a second cam member (in phantom) of the end effector, with the end effector in the configuration illustrated in FIGS. 3 and 5;

[0032] FIG. 8 is a perspective view illustrating the first cam member and the second cam member (in phantom) of the end effector, with the end effector in the configuration illustrated in FIGS. 4 and 6;

[0033] FIG. 9A is a left side view of the second cam member of FIG. 8;

[0034] FIG. 9B is a right side view of the second cam member of FIG. 8; and

[0035] FIG. 10 is a perspective view illustrating the surgical suturing instrument of FIG.

2 showing the end effector, with the jaw members of the end effector in phantom, and the needle exchange mechanism engaged with the end effector.

DETAILED DESCRIPTION

[0036] Various embodiments of the presently disclosed surgical suturing instruments for endoscopic, laparoscopic, endoluminal, and/or transluminal suturing will now be described in detail with reference to the drawings, wherein like reference numerals identify similar or identical elements. In the drawings and in the description that follows, the term “proximal” will refer to the portion of the surgical suturing instrument, or component thereof, that is closer to the user, while the term “distal” will refer to the portion of the surgical suturing instrument, or component thereof, that is farther from the user. [0037] The minimally invasive surgical suturing instruments of the disclosure generally include an elongate tubular body or shaft and an end effector. The end effector includes a curved suture needle and a pair of jaw members. In operation, the suture needle is passed back and forth through tissue from one jaw member to another jaw member by pivoting the jaw members from opened to closed configurations. Each of the jaw members includes a needle retention blade configured to selectively engage and release an end of the curved needle. The end effector further includes a central actuator having a main cam member supported at a distal end thereof, and a barrel cam operably coupled to the main cam member. The main cam member has the dual function of opening/closing the jaw members and rotating the barrel cam. The barrel cam defines a cam slot having received therein protrusions extending from proximal end portions of the respective needle retention blades such that rotation of the barrel cam, in response to translation of the main cam member, translates the needle retention blades in opposite directions. The push/pull action of the central actuator is less prone to adverse effects of articulation and tolerances, thereby avoiding loss of timing and therefore needle drop. In other words, the single degree of freedom transmitted through the instrument core, from the handle to the self-contained mechanism at the distal end, means that it is impossible to send a jaw open and needle release command simultaneously.

[0038] The disclosure further provides a needle exchange mechanism or jig that rotates the barrel cam in an opposite direction than that caused by the translation of the main cam member, whereby the needle retention blades are each reset or disengaged from the needle to permit needle exchange.

[0039] With reference to FIG. 1, a surgical robotic system 10 includes a control tower 20, which is connected to all of the components of the surgical robotic system 10 including a surgical console 30 and one or more robotic arms 40. Each of the robotic arms 40 includes a surgical instrument 100 removably coupled thereto. Each of the robotic arms 40 is also coupled to a movable cart 60.

[0040] One of the robotic arms 40 may include the endoscopic camera 51 configured to capture video of the surgical site. The endoscopic camera 51 may be a stereoscopic endoscope configured to capture two side-by-side (i.e., left and right) images of the surgical site to produce a video stream of the surgical scene. The endoscopic camera 51 is coupled to a video processing device 56, which may be disposed within the control tower 20. The video processing device 56 may be any computing device as described below configured to receive the video feed from the endoscopic camera 51 perform the image processing based on the depth estimating algorithms of the disclosure and output the processed video stream.

[0041] The surgical console 30 includes a first display 32, which displays a video feed of the surgical site provided by camera 51 of the surgical instrument 100 disposed on the robotic arms 40, and a second display 34, which displays a user interface for controlling the surgical robotic system 10. The first and second displays 32 and 34 are touchscreens allowing for displaying various graphical user inputs.

[0042] The surgical console 30 also includes a plurality of user interface devices, such as foot pedals 36 and a pair of handle controllers 38a and 38b which are used by a user to remotely control robotic arms 40. The surgical console further includes an armrest 33 used to support clinician’s arms while operating the handle controllers 38a and 38b.

[0043] The control tower 20 includes a display 23, which may be a touchscreen, and outputs on the graphical user interfaces (GUIs). The control tower 20 also acts as an interface between the surgical console 30 and one or more robotic arms 40. In particular, the control tower 20 is configured to control the robotic arms 40, such as to move the robotic arms 40 and the corresponding surgical instrument 100, based on a set of programmable instructions and/or input commands from the surgical console 30, in such a way that robotic arms 40 and the surgical instrument 100 execute a desired movement sequence in response to input from the foot pedals 36 and the handle controllers 38a and 38b.

[0044] Each of the control tower 20, the surgical console 30, and the robotic arm 40 includes a respective computer 21, 31, 41. The computers 21, 31, 41 are interconnected to each other using any suitable communication network based on wired or wireless communication protocols. The term “network,” whether plural or singular, as used herein, denotes a data network, including, but not limited to, the Internet, Intranet, a wide area network, or a local area network, and without limitation as to the full scope of the definition of communication networks as encompassed by the present disclosure. Suitable protocols include, but are not limited to, transmission control protocol/internet protocol (TCP/IP), datagram protocol/internet protocol (UDP/IP), and/or datagram congestion control protocol (DCCP). Wireless communication may be achieved via one or more wireless configurations, e.g., radio frequency, optical, Wi-Fi, Bluetooth (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs), ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-2003 standard for wireless personal area networks (WPANs)).

[0045] The computers 21, 31, 41 may include any suitable processor (not shown) operably connected to a memory (not shown), which may include one or more of volatile, nonvolatile, magnetic, optical, or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically-erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory. The processor may be any suitable processor (e.g., control circuit) adapted to perform the operations, calculations, and/or set of instructions described in the present disclosure including, but not limited to, a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), a microprocessor, and combinations thereof. Those skilled in the art will appreciate that the processor may be substituted for by using any logic processor (e.g., control circuit) adapted to execute algorithms, calculations, and/or set of instructions described herein.

[0046] With reference to FIGS. 2-10, a surgical suturing instrument in accordance with an embodiment of the disclosure is identified generally as 100. The surgical suturing instrument 100 is adapted to be particularly useful in endoscopic or laparoscopic procedures, wherein an end effector 104 of the surgical suturing instrument 100 is insertable into a surgical site, via a cannula assembly or the like. The surgical suturing instrument 100 may be operably coupled to the instrument drive unit 52 of the surgical robotic system 10 (FIG. 1) or a handle assembly (not explicitly shown). The surgical suturing instrument 100 generally includes an end effector 104 and a needle exchange mechanism 200 (FIGS. 2 and 10). The end effector 104 may be coupled to an articulatable shaft or elongated tubular portion (not explicitly shown) to adjust the pitch and/or yaw of the end effector 104.

[0047] With reference to FIGS. 2-4, the end effector 104 generally includes a proximal body portion 108, a pair of first and second jaw members 110, 112, an elongated actuator or actuation bar 120, a barrel cam 150 (FIGS. 5-9B), and first and second needle retention members or blades 160, 162. The first and second needle retention members or blades 160, 162 may be fabricated from stainless steel, spring steel, a shape memory alloy, or the like, so as to act as a respective leaf spring. In this manner, the first and second needle retention members or blades 160, 162 may be formed to bias first and second jaw members 110, 112 into an open position. This ensures that the first and second jaw members 110, 112 open fully for maximum bite depth, and also improves the usability during needle loading/unloading by holding the first and second jaw members 110, 112 in the correct position for the process described below.

[0048] The pair of first and second jaw members 110, 112 are pivotably coupled to the proximal body portion 108 via a common pivot pin 114. The proximal body portion 108 of the end effector 104 includes a proximal end portion 108a configured to be rotationally or fixedly coupled to an articulatable shaft, and a distal clevis 108b extending distally from the proximal end portion 108a. The distal clevis 108b receives respective proximal end portions 110a, 112a of the first and second jaw members 110, 112 of the end effector 104 to prevent lateral movement of the first and second jaw members 110, 112 while permitting pivoting of the first and second jaw members 110, 112 relative to one another and about the pivot pin 114 between an opened configuration (FIGS. 3 and 5) and a closed configuration (FIGS. 4 and 6). The distal clevis 108b defines a linear slot 116 through which first and second protuberances or bosses 118 of the actuation bar 120 extends.

[0049] With reference to FIGS. 2-6, the first and second jaw members 110, 112 each have the proximal end portion 110a, 112a, and a distal end portion 110b, 112b. The proximal end portions 110a, 112a each define a continuous groove or channel 122, 124 including a distal cam slot 122b (FIGS. 5-6, only the distal cam slot 122b of the first jaw member 110 is labeled) and a proximal guide slot 122a (FIGS. 5-6, only the proximal guide slot 122a of the first jaw member 110 is labeled) that extends proximally from a proximal end of the distal cam slot 122b. The bosses 118 of the actuation bar 120 extend through the respective channels 122, 124 defined in the respective proximal end portions 110a, 112a of the first and second jaw members 110, 112 such that when the bosses 118 are received in the distal cam slots 122b of the channels 122, 124, proximal translation of the actuation bar 120 closes the jaw members 110, 112 and distal translation of the actuation bar 120 opens the jaw members 110, 112. When the bosses 118 of the actuation bar 120 are received in the proximal guide slots 122a of the channels 122, 124 of the jaw members 110, 112, proximal or distal translation of the actuation bar 120 is permitted without causing an opening of the jaw members 110, 112. It is contemplated that in other aspects, distal translation of the actuation bar 120 closes the jaw members 110, 112 whereas proximal translation of the actuation bar 120 opens the jaw members 110, 112a. [0050] The distal end portion 110b, 112b of each of the jaw members 110, 112 defines a hole 128, 132 therein sized and dimensioned for detachable and/or selective receipt of a respective end 130a, 130b of a curved suture needle 130. Holes 128, 132 may extend entirely through a thickness of the first and second jaw members 110, 112, respectively. In some embodiments, the holes 128, 132 may only extend partially through a thickness of the first and second jaw members 110, 112. The holes 128, 132 are in communication with a longitudinal passageway (not labeled) extending through the respective jaw members 110, 112.

[0051] With reference to FIGS. 5-8, the elongated actuator or actuation bar 120 includes a proximal end portion 120a configured to be actuated by the instrument drive unit 52 (FIG. 1, for example, the proximal end portion 120 may be operably coupled to a drive motor of the instrument drive unit 52) or a handle assembly to drive the proximal or distal translation of the actuation bar 120 relative to the jaw members 110, 112. It is contemplated that the proximal end portion 120a of the actuation bar 120 is an elongated rigid bar or shaft. In other aspects, the proximal end portion 120a of the actuation bar 120 may be fabricated from a shape memory material, such as, for example, nickel-titanium that provides sufficient rigidity to transmit proximal forces (e.g., tensile) or distal forces (e.g., compressive), but also sufficient flexibility to pass through the articulatable shaft during articulation thereof. The actuation bar 120 further includes a distal end portion 120b axially fixed to the proximal end portion 120a.

[0052] The distal end portion 120b of the actuation bar 120 includes the bosses 118 and a distal cam member 134. The bosses 118 may extend from opposite sides of a distal end 119 of the distal end portion 120b of the actuation bar 120. The distal cam member 134 extends proximally from the distal end 119 of the actuation bar 120 and may assume a cylindrical or tubular shape. Since the distal cam member 134 is formed with or otherwise fixed to the distal end 119 of the actuation bar 120, the bosses 118 and the distal cam member 134 are configured to translate together as a single unit relative to the jaw members 110, 112 and other components of the end effector 104.

[0053] As best shown in FIGS. 7 and 8, the distal cam member 134 of the actuation bar 120 defines in an outer surface thereof diametrically opposed first and second cam slots 136, 138, and diametrically opposed first and second linear channels 140 (only the first linear channel 140 is explicitly shown) that extend proximally from the respective first and second cam slots 136, 138. At any given time, the first cam slot 136 of the distal cam member 134 receives a protuberance or pin 152a or 152b of the barrel cam 150, whereas the second cam slot 138 of the distal cam member 134 receives the other protuberance or pin 152a or 152b of the barrel cam 150. As will be described in further detail, translation of the distal cam member 134 in either a proximal or distal direction drives a rotation of the barrel cam 150 in the same rotational direction via the engagement of the protuberances 152a, 152b of the barrel cam 150 in the first and second cam slots 136, 138 of the distal cam member 134. In other aspects, the distal cam member 134 may define four (or any suitable even number) equally-spaced cam slots.

[0054] The first cam slot 136 of the distal cam member 134 includes a first portion 136a, and a second portion 136b extending distally and at an acute angle relative to a proximal end of the first portion 136a. The first portion 136a has a spiral shape and extends approximately 90 degrees about the distal cam member 134. Similarly, the second portion 136b of the first cam slot 136 has a spiral shape and extends approximately 90 degrees about the distal cam member 134. The first linear channel 140 is in communication with each of the first and second portions 136a, 136b of the first cam slot 136 such that the protuberances 152a of the barrel cam 150 may be passed from the first portion 136a of the first cam slot 136 into a proximal junction 139 that connects the first and second portions 136a, 136b and the linear channel 140, and from the proximal junction 139 into the second portion 136b of the first cam slot 136. The second cam slot 138 is similar or identical to the first cam slot 136. Accordingly, details about the second cam slot 138 are not provided herein.

[0055] With reference to FIGS. 7, 8, 9A, and 9B, the barrel cam 150 of the end effector 104 may be a hollow cylinder or tubular member defining a passageway therethrough configured for slidable receipt of the distal cam member 134 of the actuation bar 120. The protuberances 152a, 152b of the barrel cam 150 extend radially inward from diametrically opposed sides of an internal surface of the barrel cam 150 and into the passageway of the barrel cam 150. The barrel cam 150 is axially restrained within the proximal end portion 108a of the proximal body portion 108 of the end effector 104, for example, by a wire clip 106 (FIG. 3). It is contemplated that the barrel cam 150 may be axially restrained within the proximal body portion 108 via other suitable fasteners or mechanisms such as being keyed to the proximal body portion 108.

[0056] As best shown in FIGS. 9A and 9B, the barrel cam 150 defines a cam slot 156 in an outer surface thereof having received therein respective pins or protrusions 170, 172 of the respective first and second needle retention blades 160, 162. The cam slot 156 may have a helical shape and is a closed loop extending around the entire circumference of the barrel cam 150. The cam slot 156 includes a first half section 156a (FIG. 9A), and a second half section 156b (FIG. 9B). The first half section 156a of the cam slot 156 is configured to drive one of the protrusions 170 or 172 of the first and second needle retention blades 160, 162 in a proximal direction as the protrusion 170 or 172 traverses the first half section 156a of the cam slot 156 during rotation of the barrel cam 150 in the direction indicated by arrow “A” in FIG 8. The second half section 156b of the cam slot 156 is configured to drive one of the protrusions 170 or 172 of the first and second needle retention blades 160, 162 in a distal direction as the protrusion 170 or 172 traverses the second half section 156b of the cam slot 156 during rotation of the barrel cam in direction “A.”

[0057] The barrel cam 150 further defines a discrete slot 158 (FIGS. 6 and 9A) in communication with the first half section 156a of the cam slot 156. The discrete slot 158 extends in a circumferential direction of the barrel cam 150 rather than in a helical or spiral fashion. As such, when one of the protrusions 170 or 172 of one of the first or second needle retention blades 160, 162 is diverted into the discrete slot 158 due to a rotation of the barrel cam 150 in a second rotational direction (e.g., clockwise when viewed in a proximal-to- distal direction), the discrete slot 158 of the barrel cam 150 is configured to maintain an axial position of the protrusion 170 or 172. The barrel cam 150 may further include gear teeth 168 extending circumferentially about a proximal end thereof.

[0058] With reference to FIGS. 3-8, the needle retention blades 160, 162 of the end effector 104 extend through the passageways defined through the respective first and second jaw members 110, 112 and are configured to slide relative to the first and second jaw members 110, 112. Each of the first and second needle retention blades 160, 162 includes a proximal end portion 160a, 162a (FIGS. 4 and 5) protruding proximally from the jaw members 110, 112, and a distal end portion 160b, 162b positioned adjacent the hole 128, 132 in the jaw members 110, 112. The proximal end portion 160a, 162a of each of the needle retention blades 160, 162 includes a pin or protrusion 170, 172 received in the cam slot 156 of the barrel cam 150 such that the first and second needle retention blades 160, 162 are configured to translate in opposite directions in response to the rotation of the barrel cam 150. The distal end portions 160b, 162b of the needle retention blades 160, 162 are configured to selectively overlap with the respective holes 128, 132 of the first and second jaw members 110, 112 to selectively engage respective radial slots formed in each of the first and second ends 130a, 130b of the needle 130.

[0059] For example, when the first end 130a of the needle 130 is disposed within the hole 128 of the first jaw member 110, and when the distal end portion 160b of the needle retention blade 160 is in a distal position, the distal end portion 160b of the needle retention blade 160 extends at least partially across the hole 128 of the first jaw member 110 and into the slot formed in the first end 130a of the needle 130, to thereby retain the needle 130 within the first jaw member 110. Comparably, the same engagement occurs for the needle 130 within the second jaw member 120 via the needle retention blade 162.

[0060] With reference to FIGS. 2 and 10, the needle exchange mechanism or jig 200 is a separate component from the end effector 104 and is configured to retract the needle retention blade 160 or 162 that is engaged with the needle 130 at any given time to allow for removal of the needle 130 from (or loading of the needle into) the end effector 104. The jig 200 includes a base 202, a proximal stem 204 projecting from a proximal end of the base 202, and a distal stem 206 projecting from a distal end of the base 202. The distal stem 206 of the jig 200 defines a lateral slot 208 therein configured to receive and support the needle 130. The proximal stem 204 defines a passage 210 configured for receipt of the barrel cam 150 while permitting rotation of the barrel cam 150 within the passage 210. The proximal stem 204 further defines an annular opening 214 in communication with the passage 210 and configured to permit an axial passage of the entire end effector 104 including the barrel cam 150 therethrough. The proximal stem 204 includes a plurality of teeth 216 extending into the passage 210 and configured for meshing engagement with the gear teeth 168 at the proximal end of the barrel cam 150.

[0061] In operation, to perform a minimally invasive procedure involving a suturing of tissue, for example, a hernia repair, an access tube or cannula is positioned through surface tissue of a patient to gain access to the surgical site within a body of the patient. Surgical suturing instrument 100 is passed through the cannula to position jaw members 110, 112, with curved needle 130, adjacent the subject tissue. To pass curved needle 130 (having a suture attached thereto) through the tissue to suture the tissue, jaw members 110, 112 are pivoted about the pivot pin 114 from a spaced-apart position to an approximated position.

[0062] To pivot the jaw members 110, 112 from an opened configuration (FIG. 3) to a closed configuration (FIG. 4), the actuation bar 120 is moved proximally (e.g., via actuation by the instrument drive unit 52 or a handle assembly), whereby the bosses 118 of the actuation bar 120 move proximally through the distal cam slots 122b of the jaw members 110, 112 to pivot the jaw members 110, 112 toward one another. While the bosses 118 of the actuation bar 120 are moving through the distal cam slots 122b of the first and second jaw members (FIG. 5) to pivot the jaw members 110, 112, the first and second protuberances 152a, 152b of the barrel cam 150 (FIG. 7) are guided through the respective first and second linear channels 140 of the distal cam member 134 of the actuation bar 120. In this way, the barrel cam 150 does not rotate during the pivoting of the jaw members 110, 112.

[0063] Approximation of the distal end portions 110b, 112b of the jaw members 110, 112 is continued until the hole 132 of second jaw member 112 receives the second end 130b of the curved needle 130. At this point, the bosses 118 of the actuation bar 120 are moved proximally out of the distal cam slot 122b of the channels 122, 124 of the jaw members 110, 112 and into the proximal guide slots 122b of the channels 122, 124 of the jaw members 110, 112 such that further proximal translation of the actuation bar 120 does not result in a further pivoting of the jaw members 110, 112.

[0064] With the jaw members 110, 112 in the closed configuration, to simultaneously release the first end 130a of the curved needle 130 from the first jaw member 110 and secure the second end 130b of the curved needle 130 with the second jaw member 112, the actuation bar 120 is further translated proximally to simultaneously move the bosses 118 of the actuation bar 120 proximally through the proximal guide slots 122b of the jaw members 110, 112 and guide or cam the protuberances 152a, 152b of the barrel cam 150 with the first and second cam slots 136, 138 of the distal cam member 134. As such, during this stage of operation, the jaw members 110, 112 remain in the closed configuration as the barrel cam 150 rotates in the first rotational direction, as indicated by arrow “A” in FIG. 8, approximately 90 degrees. With reference to FIG. 7, as the distal cam member 134 moves proximally relative to the protuberances 152a, 152b of the barrel cam 150, the protuberance 152a moves from the proximal junction 139 into the second portion 136b of the first cam slot 136 and the protuberance 152b moves from the opposing proximal junction (not explicitly shown) into the second portion of the second cam slot 138.

[0065] Since the protrusions 170, 172 of the first and second needle retention blades 160, 162 are received in the respective first and second half sections 156a, 156b of the cam slot 156 of the barrel cam 150, the rotation of the barrel cam 150 in direction “A” translates the first needle retention blade 160 from a distal position (FIG. 5) toward a proximal position (FIG. 6). Likewise, the second needle retention blade 162 is translated from a proximal position (FIG. 5) toward a distal position (FIG. 6).

[0066] It is contemplated that the rotation of the barrel cam 150 the initial 90 degrees does not translate the first and second needle retention blades 160, 162 a sufficient distance to complete the transfer of the needle 130 from the first jaw member 110 to the second jaw member 112. Accordingly, the barrel cam 150 is rotated an additional 90 degrees by translating the actuation bar 120 distally from the position shown in FIG. 8 to guide the protuberance 152a of the barrel cam 150 through the first portion (not labeled) of the second cam slot 138. Likewise, the protuberance 152b of the barrel cam 150 is guided through the first portion 136a of the first cam slot 136. The distal translation of the actuation bar 120 may be continued until the protuberances 152a, 152b of the barrel cam 150 enter the respective proximal junctions 139 of the distal cam member 134 of the actuation bar 120, at which time the distal end portion 160b of the first needle retention blade 160 disengages the first end 130a of the curved needle 130, and the distal end portion 162b of the second needle retention blade 162 engages the second end 130b of the needle 130. In this state, the transfer of the needle 130 from the first jaw member 110 to the second jaw member 112 is complete.

[0067] With the second needle retention blade 162 now secured to the second end 130b of the needle 130 and the first end 130a of the needle 130 released from the first needle retention blade 160, the jaw members 110, 112 may be transitioned to the opened configuration. To transition the jaw members 110, 112 to the opened configuration, the actuation bar 120 is translated distally whereby the bosses 118 of the actuation bar 120 move distally from the proximal guide slots 122a of the jaw members 110, 112 to the distal cam slots 122b of the jaw members 110, 112 to transition the jaw members 110, 112 from the closed configuration (FIGS. 4 and 6) toward the opened configuration (FIG. 3 and 5). Concurrently, as the actuation bar 120 is translated distally, the protuberances 152a, 152b of the barrel cam 150 are guided axially (relatively) through the linear channels 140 of the distal cam member 150 (as shown in FIG. 8) such that the barrel cam 150 maintains its rotational orientation. As such, the first and second needle retention blades 160, 162 maintain their respective axial positions while the jaw members 110, 112 are transitioning toward the opened configuration. This process may be continued until the surgical procedure is completed.

[0068] It may be desirable to remove the needle 130 from the end effector 104, for example, to replace a spent needle with a new needle. However, the normal operation of the end effector 104 may not result in a circumstance where both of the needle retention blades 160, 162 are disengaged from the needle 130. Accordingly, the needle exchange jig 200 (FIGS. 2 and 10) is provided and is used to disengage the one needle retention blade 160 or 162 from the needle 130 without also causing the other needle retention blade 160 or 162 to re-engage the needle 130. During the following description of the operation of the jig 200, it is assumed that the end effector 104 is in a state where the first needle retention blade 160 is engaged with the needle 130 and the second needle retention blade 162 is disengaged from the needle 130.

[0069] With reference to FIG. 10, with the jaw members 110, 112 in the opened configuration, the barrel cam 150 along with the entire end effector 104 is moved downwardly through the passage 210 in the proximal stem 204 of the jig 200, whereby the gear teeth 216 of the jig 200 engage the gear teeth 168 of the barrel cam 150 to rotate the barrel cam 150 in the second rotational direction (e.g., clockwise when viewed in a proximal-to-distal direction), as indicated by arrow “B” in FIG. 10. The rotation of the barrel cam 150 in the second rotational direction causes the protrusion 172 of the second needle retention blade 162 to enter the discrete slot 158 of the barrel cam 150, as shown in FIG. 10. As such, continued rotation of the barrel cam 150 in the second rotational direction does not result in any movement of the second needle retention blade 162. However, since the protrusion 170 of the first needle retention blade 160 remains in the cam slot 156 of the barrel cam 150, the rotation of the barrel cam 150 in the second rotational direction drives the proximal translation of the first needle retention blade 160 to disengage the distal end portion 160b of the first needle retention blade 160 from the needle 130.

[0070] With neither the first needle retention blade 160 nor the second needle retention blade 162 engaged with the needle 130, the needle 130 may be removed from the end effector 130. After removing the needle 130, the new needle may be supported in the lateral opening 208 in the distal stem 206 of the jig 200, and the jaw members 110, 112 may be closed to capture the needle 130 between the jaw members 110, 112. With the jaw members 110, 112 in the closed configuration, the actuation bar 120 may be actuated in the manner described above to engage one of the first or second needle retention blades 160, 162 with the needle 130. With the needle 130 secured to one of the jaw members 110, 112, the jig 200 may be removed by moving the jig 200 distally relative to the end effector 104. After removing the jig 200, the jaw members 110, 112 may be transitioned to the opened configuration.

[0071] It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely exemplifications of embodiments. Those skilled in the art will envision other modification within the scope and spirit of the claims appended thereto.

Claims

WHAT IS CLAIMED IS:

1. A surgical suturing instrument, comprising: a first jaw member; a second jaw member operably coupled to the first jaw member; an actuation bar configured to translate relative to the first and second jaw members to pivot the first and second jaw members between opened and closed configurations; a first needle retention blade movable within the first jaw member; a second needle retention blade movable within the second jaw member; and a cam member coupled to a distal end portion of the actuation bar and configured to rotate in a first rotational direction relative to the distal end portion of the actuation bar in response to a proximal or distal movement of the actuation bar, wherein each of the first and second needle retention blades has a proximal end portion coupled to the cam member such that the first and second needle retention blades are configured to translate in opposite directions in response to the rotation of the cam member in the first rotational direction.

2. The surgical suturing instrument according to claim 1 , wherein the cam member is a barrel cam configured to rotate in the first rotational direction in response to each of the proximal movement of the actuation bar and the distal movement of the actuation bar.

3. The surgical suturing instrument according to claim 2, wherein the distal end portion of actuation bar includes a cam member defining a pair of first and second cam slots configured to rotate the barrel cam in the first rotational direction relative to the cam member.

4. The surgical suturing instrument according to claim 3, wherein the barrel cam is configured to slidably receive the cam member of the actuation bar.

5. The surgical suturing instrument according to claim 3, wherein the first cam slot includes: a first portion configured to rotate the barrel cam in the first rotational direction during the distal movement of the actuation bar; and a second portion configured to rotate the barrel cam in the first rotational direction during the proximal movement of the actuation bar.

6. The surgical suturing instrument according to claim 3, wherein the barrel cam includes first and second protrusions received in the respective first and second cam slots.

7. The surgical suturing instrument according to claim 6, wherein the cam member of the actuation bar defines first and second linear channels extending proximally from the respective first and second cam slots, the barrel cam being configured to maintain a rotational orientation thereof in response to distal or proximal movement of the actuation bar when the first and second protrusions of the barrel cam are received in the respective first and second linear channels.

8. The surgical suturing instrument according to claim 7, wherein the first jaw member includes a proximal end portion defining a distal cam slot and a proximal guide slot extending proximally from the distal cam slot, the actuation bar including a boss extending from the distal end portion of the actuation bar, the boss of the actuation bar being configured to pivot the first jaw member during translation of the boss through the distal cam slot.

9. The surgical suturing instrument according to claim 8, wherein the boss of the actuation bar is configured to be received in the distal cam slot of the first jaw member when the first and second protrusions of the barrel cam are received in the respective first and second linear channels of the cam member, and the boss of the actuation bar is configured to be received in the proximal guide slot of the first jaw member when the first and second protrusions of the barrel cam are received in the respective first and second cam slots of the cam member.

10. The surgical suturing instrument according to claim 1, wherein the cam member defines a cam slot, each of the first and second needle retention blades having a protrusion extending from the proximal end portion thereof and into the cam slot of the cam member.

11. The surgical suturing instrument according to claim 10, wherein the cam member includes a discrete slot in communication with the cam slot, the discrete slot being configured to maintain an axial position of the first or second protrusion of one of the first or second needle retention blades when the cam member rotates in a second rotational direction, opposite the first rotational direction.

12. The surgical suturing instrument according to claim 1, wherein each of the first and second needle retention blades has a distal end portion configured to engage a respective end portion of a needle to selectively retain the needle with the first or second jaw members.

13. An end effector of a surgical suturing instrument, the end effector comprising: a body portion; a first jaw member pivotably coupled to the body portion and including a proximal end portion defining a first cam slot, and a distal end portion defining a hole configured for detachable receipt of a first end of a needle; a second jaw member coupled to the body portion and including a proximal end portion defining a second cam slot, and a distal end portion defining a hole configured for detachable receipt of a second end of the needle; first and second protuberances received in the respective first and second cam slots and configured to translate through the first and second cam slots to move the first and second jaw members relative to one another between opened and closed configurations; a first cam member configured to translate relative to the body portion and defining first and second cam slots; a second cam member including first and second protrusions received in the respective first and second cam slots of the first cam member such that the second cam member rotates relative to the first cam member as the first cam member translates relative to the body portion, the second cam member defining a cam slot; and first and second needle retention members extending through the respective first and second jaw members and each including a proximal end portion engaged with the cam slot of the second cam member such that the first and second needle retention members are configured to translate in opposite directions in response to the rotation of the second cam member.

14. The end effector according to claim 13, further comprising an actuation bar including a proximal end portion, and a distal end portion including the first cam member and the first and second protuberances such that the first cam member and the first and second protuberances translate together relative to the body portion as the actuation bar translates.

15. The end effector according to claim 14, wherein the second cam member is a barrel cam configured to rotate in a first rotational direction in response to each of a proximal movement of the actuation bar and a distal movement of the actuation bar.

16. The end effector according to claim 15, wherein the barrel cam is configured to slidably receive the first cam member.

17. The end effector according to claim 15, wherein the first cam slot of the first cam member includes: a first portion configured to rotate the barrel cam in the first rotational direction during the distal movement of the actuation bar; and a second portion configured to rotate the barrel cam in the first rotational direction during the proximal movement of the actuation bar.

18. An end effector, comprising: a body portion; first and second jaw members each coupled to the body portion; a first needle retention member slidably received within the first jaw member; a second needle retention member slidably received within the second jaw member; an elongated actuator including a distal end portion operably coupled to at least one of the first or second jaw members to transition the first and second jaw members between an opened configuration and a closed configuration; and a rotatable cam member coupled to the distal end portion of the elongated actuator and configured to rotate in a first rotational direction relative to the distal end portion of the elongated actuator in response to a proximal or distal movement of the distal end portion of the elongated actuator, wherein each of the first and second needle retention members includes a proximal end portion operably coupled to the rotatable cam member such that the first and second needle retention members are configured to translate in opposite directions in response to the rotation of the rotatable cam member.

19. The end effector according to claim 18, wherein the distal end portion of the elongated actuator includes a cam member configured for slidable receipt within the rotatable cam member, the cam member of the elongated actuator defining a pair of first and second cam slots and the rotatable cam member including first and second protrusions configured for receipt in the respective first and second cam slots.

20. The end effector according to claim 19, wherein the first jaw member defines a hole configured for detachable receipt of a first end of a needle and the second jaw member defines a hole configured for detachable receipt of a second end of the needle, the first and second needle retention members each including a proximal end portion configured for receipt in a helical slot defined in the rotatable cam member, and a distal end portion configured to overlap with the respective holes of the first and second jaw members to selectively engage one of the first or second ends of the needle.