US20070106317A1 - Hydraulically and electrically actuated articulation joints for surgical instruments - Google Patents
Hydraulically and electrically actuated articulation joints for surgical instruments Download PDFInfo
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- US20070106317A1 US20070106317A1 US11/270,866 US27086605A US2007106317A1 US 20070106317 A1 US20070106317 A1 US 20070106317A1 US 27086605 A US27086605 A US 27086605A US 2007106317 A1 US2007106317 A1 US 2007106317A1
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- tube segment
- surgical instrument
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- proximal tube
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
- A61B17/105—Wound clamp magazines
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0645—Surgical staples, i.e. penetrating the tissue being elastically deformed for insertion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07242—Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2925—Pistol grips
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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- Surgical Instruments (AREA)
Abstract
Articulation joints for use in connection with a surgical instrument that has a portion that must be passed through a trocar or similar structure and then articulated relative to another portion of the instrument received within the trocar. Various embodiments of the articulation joint include at least one fluid-actuated cylinder or flexible driven member to articulate the surgical implement relative to the handle assembly of the instrument.
Description
- The present invention relates in general to surgical instruments that are suitable for endoscopically inserting an end effector (e.g., endocutter, grasper, cutter, staplers clip applier, access device, drug/gene therapy delivery device, an energy device using ultrasound, RF, laser, etc.) and, more particularly, to endocutters with articulating end effectors.
- Endoscopic surgical instruments are often preferred over traditional open surgical devices since a smaller incision tends to reduce the post-operative recovery time and complications. Generally, these endoscopic surgical instruments include an “end effector”, a handle assembly and a long shaft that extends between the end effector and the handle assembly. The end effector is the portion of the instrument configured to engage the tissue in various ways to achieve a desired diagnostic or therapeutic effect (e.g., endocutter, grasper, cutter, staplers, clip applier, access device, drug/gene therapy delivery device, and energy device using ultrasound, RF, laser, etc.). The end effector and the shaft portion are sized to be inserted through a trocar placed into the patient. The elongated shaft portion enables the end effector to be inserted to a desired depth and also facilitates some rotation of the end effector to position it within the patient. With judicious placement of the trocar and use of graspers, for instance, through another trocar, often this amount of positioning is sufficient. Surgical stapling and severing instruments, such as those described in U.S. Pat. No. 5,465,895, are an example of an endoscopic surgical instrument that successfully positions an end effector by insertion and rotation.
- Depending upon the nature of the operation, it may be desirable to further adjust the positioning of the end effector of an endoscopic surgical instrument. In particular, it is often desirable to orient the end effector at an angle relative to the longitudinal axis of the shaft of the instrument. The transverse or non-axial movement of the end effector relative to the instrument shaft is often conventionally referred to as “articulation”. This articulated positioning permits the clinician to more easily engage tissue in some instances, such as behind an organ. In addition, articulated positioning advantageously allows an endoscope to be positioned behind the end effector without being blocked by the instrument shaft.
- Approaches to articulating a surgical stapling and severing instrument tend to be complicated by integrating control of the articulation along with the control of closing the end effector to clamp tissue and fire the end effector (i.e., stapling and severing) within the small diameter constraints of an endoscopic instrument. Generally, the three control motions are all transferred through the shaft as longitudinal translations. For instance, U.S. Pat. No. 5,673,840 discloses an accordion-like articulation mechanism (“flex-neck”) that is articulated by selectively drawing back one of two connecting rods through the implement shaft, each rod offset respectively on opposite sides of the shaft centerline. The connecting rods ratchet through a series of discrete positions.
- Another example of longitudinal control of an articulation mechanism is U.S. Pat. No. 5,865,361 that includes an articulation link offset from a camming pivot such that pushing or pulling longitudinal translation of the articulation link effects articulation to a respective side. Similarly, U.S. Pat. No. 5,797,537 discloses a similar rod passing through the shaft to effect articulation. Still other examples of articulatable surgical stapling devices are disclosed in U.S. Patent Nos. 6,250,532 and 6,644,532.
- Due to the types end effector firing systems commonly employed, the actuator arrangements for articulating the end effector must often generate high amounts of torque to bend the firing structure. This problem is exacerbated by the lack of available space for accommodating actuating devices that are large enough to generated those required forces.
- Consequently, a significant need exists for an articulating surgical instrument that incorporates an articulation mechanism that can generate the torque necessary to selectively articulate the end effector thereof in a desired manner.
- In accordance with one embodiment of the present invention there is provided a surgical instrument that comprises a handle assembly and a proximal tube segment that is attached to the handle assembly. The surgical instrument further comprises a distal tube segment that is attached to the proximal tube segment by an articulating joint assembly. In one non-limiting embodiment, the articulating joint assembly comprises a ball member non-movably coupled to an end of one of the proximal and distal tube segments and being rotatably received in a corresponding socket in an end of the other of the proximal tube segment and distal tube segments. An actuator assembly is coupled between the ends of the distal and proximal tube segments and serves to retain a portion of the ball member in the socket. The actuator assembly further selectively rotates the ball member portion within the socket to articulate the distal tube segment relative to the proximal tube segment. A surgical implement may be attached to the distal tube segment.
- In accordance with another non-limiting embodiment of the present invention there is provided a surgical instrument that comprises a handle assembly and a proximal tube segment that is attached to the handle assembly. The surgical instrument further comprises a distal tube segment that is attached to the proximal tube segment by an articulating joint assembly. In one non-limiting embodiment, the articulating joint assembly comprises a ball member non-movably coupled to an end of one of the proximal and distal tube segments and being rotatably received in a corresponding socket in an end of the other of the proximal tube segment and distal tube segment. An actuator assembly is coupled between the one of the distal and proximal tube segments that has the socket therein and a portion of the ball member and serves to retain a portion of the ball member in the socket. The actuator assembly further selectively rotates the ball member portion within the socket to articulate the distal tube segment relative to the proximal tube segment. A surgical implement may be attached to the distal tube segment.
- In accordance with another embodiment of the present invention there is provided a surgical instrument that comprises a handle assembly and a proximal tube segment that is attached to the handle assembly. The surgical instrument further comprises a distal tube segment that is attached to the proximal tube segment by an articulating joint assembly. In one non-limiting embodiment, the articulating joint assembly comprises a disc-like member non-movably coupled to an end of one of the proximal and distal tube segments and being rotatably received in a corresponding socket in an end of the other of the proximal tube segment and distal tube segment. An actuator assembly is coupled between the ends of the distal and proximal tube segments and serves to retain a portion of the disc-like member in the socket. The actuator assembly further selectively rotates the disc-like member portion within the socket to articulate the distal tube segment relative to the proximal tube segment. A surgical implement may be attached to the distal tube segment.
- In accordance with another non-limiting embodiment of the present invention there is provided a surgical instrument that comprises a handle assembly and a proximal tube segment that is attached to the handle assembly. The surgical instrument further comprises a distal tube segment that is attached to the proximal tube segment by an articulating joint assembly. In one non-limiting embodiment, the articulating joint assembly comprises a disc-like member non-movably coupled to an end of one of the proximal and distal tube segments and being rotatably received in a corresponding socket in an end of the other of the proximal tube segment and distal tube segment. An actuator assembly is coupled between the one of the distal and proximal tube segments that has the socket therein and a portion of the disk-like member and serves to retain a portion of the disc-like member in the socket. The actuator assembly further rotates the disc-like member portion within the socket to articulate the distal tube segment relative to the proximal tube segment. A surgical implement may be attached to the distal tube segment.
- One feature of various embodiments of the present invention is to provide an articulation joint that enables the proximal and distal tube segments to be coaxially aligned for insertion through a passageway in a trocar and then articulated relative to each other after the joint has passed through the trocar. Accordingly, various embodiments of the invention provide solutions to the shortcomings of other articulated surgical instruments that are designed to be passed through a trocar or similar structure. Those of ordinary skill in the art will readily appreciate, however, that these and other details, features and advantages will become further apparent as the following Detailed Description proceeds.
- The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention, and, together with the general description of the invention given above, and the detailed description of the embodiments given below, serve to explain various principles of the various embodiments of the present invention.
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FIG. 1 is a partial perspective view of one non-limiting embodiment of a moment arm extension arrangement employed in connection with a hydraulically operated endocutter with the tube segments thereof in a first substantially coaxially aligned position; -
FIG. 2 is another perspective view of the moment arm extension arrangement and endocutter ofFIG. 1 with the tube segments articulated at an angle relative to each other; -
FIG. 3 is a partial cross-sectional view of an end effector employed in the endocutter depicted inFIGS. 1 and 2 with the anvil thereof in an open or unclamped position with some of the elements thereof omitted for clarity; -
FIG. 4 is another cross-sectional view of the end effector ofFIG. 3 in a closed or clamped position with the cutting bar in an extended position; -
FIG. 5 is another cross-sectional view of the end effector ofFIGS. 3 and 4 showing tissue after being cut and stapled therein; -
FIG. 6 is an exploded perspective view of the end effector depicted inFIGS. 1-5 ; -
FIG. 7 is another exploded assembly view of the end effector and a staple cartridge; -
FIG. 8 is a plan view of a staple cartridge installed in an end effector depicted inFIGS. 6 and 7 ; -
FIG. 9 is a cross-sectional end view illustrating the end effector inserted into a trocar passageway; -
FIG. 10 is a perspective view of a cartridge installed in an end effector with the anvil thereof in an open or unclamped position; -
FIG. 11 is a schematic depiction of one hydraulic system embodiment of the present invention; -
FIG. 12 is a partial perspective view of one non-limiting embodiment of an articulation joint of the present invention in an articulated position; -
FIG. 13 is another partial perspective view of the articulation joint depicted inFIG. 12 in an articulated position; -
FIG. 14 is another partial perspective view of the articulation joint embodiment depicted inFIGS. 12 and 13 in an articulated position; -
FIG. 15 is a partial cross-sectional view of another non-limiting embodiment of an articulation joint of the present invention in an articulated position; -
FIG. 15A is a partial cross-sectional view of another articulation joint of the present invention in an articulated position; -
FIG. 16 is a partial cross-sectional view of another articulation joint of the present invention in an articulated position; -
FIG. 16A is a partial cross-sectional view of another articulation joint of the present invention in an articulated position; -
FIG. 17 is a partial cross-sectional view of another articulation joint embodiment of the present invention in an articulated position; and -
FIG. 17A is a partial cross-sectional view another articulation joint of the present invention in an articulated position. - Turning to the Figures, wherein like numerals denote like components throughout the several views,
FIGS. 1 and 2 depict one embodiment of asurgical instrument 10 that is capable of practicing the unique benefits of the present invention. As can be seen inFIGS. 1 and 2 , theinstrument 10 includes ahandle assembly 200 and a surgical implementportion 12. As used herein, the term “surgical implement” refers to a component or set of components configured to engage tissue to accomplish a surgical task. Examples of surgical implements include, but are not limited to: endocutters, graspers, clamps, cutters, staplers, clip appliers, probes or access devices, drug/gene therapy delivery devices, energy devices such as ultrasound, RF, or laser devices, etc. - In the non-limiting embodiment depicted in the Figures, the
surgical instrument 10 includes a hydraulically actuatedend effector 22 and handlearrangement 200 of the type disclosed in the U.S. patent application Ser. No. ______, entitled “SURGICAL INSTRUMENT HAVING A HYDRAULICALLY ACTUATED END EFFECTOR” to Frederick E. Shelton IV and Jerome R. Morgan, that was filed on even date herewith and which is commonly owned with the present application and which the disclosure thereof is hereby incorporated by reference in its entirety. As the present Detailed Description proceeds, however, the skilled artisan will readily appreciate that the unique and novel features of the various embodiments of the present invention may also be employed in connection with electrically actuated or pneumatically actuated end effectors. Thus, the various embodiments of the present invention may be advantageously employed in connection with a variety of surgical implements other than the exemplary embodiment depicted in the Figures without departing from the spirit and scope of the present invention. Accordingly, the scope of protection afforded to the various embodiments of the present invention should not be limited to use only with the specific type of surgical implements specifically described herein. - Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
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FIGS. 3-10 show views of one type ofend effector 22 configured to perform clamping, severing and stapling of tissue according to various embodiments the present invention. In one embodiment, theend effector 22 has abody portion 24 that is provided with anelongate channel 26 for receiving astaple cartridge 60 therein. Ananvil 28 is coupled to thebody portion 24 and is capable of being selectively pivoted toward and away fromcartridge 60 mounted in theelongate channel 26.FIGS. 3 and 10 illustrate theanvil 28 in an open position andFIGS. 4 and 5 illustrate theanvil 28 in a closed position. Theanvil 28 may be closed hydraulically and returned to its open position by an energy storing device such as aspring 23. As can be seen inFIGS. 3-5 , anactuation bladder 40 may be strategically mounted below a portion of theanvil 28 such that when thebladder 40 is inflated with a pressurized fluid or air, it biases theanvil 28 to its open position. Asupply line 42 is coupled to thebladder 40 for supplying pressurized fluid from areservoir 232 as will be described in further detail below. In alternative non-limiting embodiments, an additional hydraulic cylinder or cylinders may be advantageously employed to open and close the anvil. Still in other non-limiting embodiments, theanvil 28 may be opened and closed by slidable action of adistal tube segment 410 attached thereto. - One type of cartridge that may be used with such end effector is also depicted in
FIGS. 3-10 . Thestaple cartridge 60 has acartridge body 62 that is divided by anelongated cutting slot 64 that extends from aproximal end 65 of thecartridge 60 toward a taperedouter tip 66. SeeFIG. 10 . A plurality of staple-receivingchannels 68 are formed within thestaple cartridge body 64 and are arranged in spacedlongitudinal rows 69 on each side of theelongated cutting slot 64. Positioned within the staple-receiving channels arestaple drivers 70 that each support one ormore staples 72 thereon. Thestaples 72 are advanced or “fired” by moving theirrespective drivers 70 in an upward direction toward theanvil 28. -
FIG. 10 depicts a three dimensional view of theend effector 22 in an open position with astaple cartridge 60 installed in theelongate channel 26. On alower surface 30 of theanvil 28, a plurality of staple-formingpockets 32 are arrayed to correspond to eachstaple receiving channel 68 in thecartridge body 62 when thecartridge 60 is installed in theend effector 22. More specifically, each formingpocket 32 in theanvil 28 may correspond to anindividual staple 72 located within thestaple cartridge 60. Thestaple cartridge 60 may be snap-fit into theelongate channel 26. For example, extension features 63 of thestaple cartridge 60 engage recesses 27 (shown inFIG. 6 ) of theelongate channel 26. - In one embodiment, the
staple drivers 70 are driven in an “upward” (toward the anvil 28) direction by a series of hydraulically actuatedbladders elongated slot 26 of theend effector 22 and arranged such that when thebladders drivers 70 and theirrespective staples 72 toward theanvil 28. As the ends of the staple legs contact the correspondingstaple forming pockets 32 in theanvil 28, they are bent over to close thestaple 72. Various firing arrangements are disclosed in the abovementioned patent application entitled SURGICAL INSTRUMENT HAVING A HYDRAULICALLY ACTUATED END EFFECTOR” which has been herein incorporated by reference. Pressurized fluid or air is supplied to thebladders FIGS. 6 and 11 . - Also in one embodiment, to facilitate cutting of
tissue 8 clamped in theend effector 22, a hydraulically actuated cuttingbar 110 is operatively mounted within theelongated channel 26 and arranged to be received within theelongated slot 64 in thecartridge body 62 when thecartridge 60 is mounted within theend effector 22. The cuttingbar 110 extends longitudinally along theelongate slot 64 and is mechanically coupled to or otherwise supported on asupport bar 111 which is attached to ahydraulic cutting bladder 102. By introducing a pressurized fluid or air into the cuttingbladder 102, the cuttingbar 110 is forced upward (represented by arrow A inFIG. 4 ) thereby causing the cuttingbar 110 to sever thetissue 8 that is clamped between theanvil 28 and thecartridge 60. After the cuttingbar 110 has severed thetissue 8, the pressurized fluid is permitted to exit the cuttingbladder 102 to thereby permit thebladder 102 to deflate and permit the cuttingbar 110 to move downward (arrow “B” inFIG. 3 ) to its retracted or unfired position. Pressurized fluid or air is supplied to the cuttingbladder 102 bysupply line 256. - As can be seen in
FIGS. 1 and 2 , thehandle assembly 200 may house a hydraulic system generally designated as 210 for controlling the operation of theend effector 22. One embodiment of ahydraulic system 210 that may be employed to control theend effector 22 is depicted in schematic form inFIG. 11 . In this non-limiting embodiment, a conventionalhydraulic pump assembly 230 that includes afluid reservoir 232 is employed to supply pressurized fluid to the various bladders. In one embodiment, thepump 230 is powered by abattery 234 supported within thehandle assembly 200. However, thepump 230 could also be powered by other means, such as by alternating current or by a mechanical actuator. Thepump 230 may be fluidically coupled to thereservoir 232 bysupply line 236 that may have aconventional check valve 238 therein. SeeFIG. 11 . As used herein, the term “fluidically coupled” means that the elements are coupled together with an appropriate supply, return, discharge, etc. line or other means to permit the passage of pressurized fluid medium, air, etc. therebetween. As used herein, the term “line” as used in “supply line”, “discharge line” or “return line” refers to an appropriate fluid passage formed from conduit, pipe, tubing, etc. for transporting pressurized fluid, air, etc. from one component to another. - In one embodiment, a
discharge line 240 attached to thedischarge port 231 of thepump 230 is piped to a manifold 242 that has designated supply lines for each bladder coupled thereto. For example, in the embodiment depicted inFIG. 11 , asupply line 244 is coupled tobladder 90 and has acontrol valve 260 therein for controlling the flow of pressurized fluid through theline 244 tobladder 90.Supply line 246 is coupled tobladder 92 and has acontrol valve 262 therein.Supply line 248 is coupled tobladder 94 and has acontrol valve 264 therein.Supply line 250 is coupled tobladder 96 and has a control valve 266 therein.Supply line 252 is coupled tobladder 98 and has a control valve 268 therein.Supply line 254 is coupled tobladder 100 and has a control valve 270 therein.Supply line 256 is coupled to cuttingbladder 102 and hascontrol valve 272 therein.Supply line 42 is coupled to theanvil bladder 40 and thesupply line 240 byline 241. Asupply valve 274 is provided inline 241 for controlling the flow of pressurized fluid thereto and areturn valve 276 is provided to permit the fluid to return from thebladder 40 into themanifold line 242 and through areturn line 259 that is attached to the manifold 242 and thereservoir 232. As can be seen inFIG. 11 , thereturn line 259 may have areturn valve 278 therein.Valves valves - The above-described valves may be operated by a
control circuit 300 in response to input received from input buttons, such asbuttons battery 234 and comprise a suitable circuit capable of generating signals for configuringvalve unit 280 in response to input frombuttons closure trigger 206 and/or afiring trigger 208 that are pivotally coupled thereto. In one non-limiting embodiment, thecontrol circuit 300 may include a microprocessor and other related components including Random Access Memory (RAM), Read Only Memory (ROM), etc. In other non-limiting embodiments, thecontrol circuit 300 may include various logical circuit elements. - As can be seen in
FIGS. 1 and 2 , in one non-limiting embodiment, thehandle assembly 200 of theinstrument 10 includes apistol grip 204 that includes aclosure trigger 206 that is pivotally attached thereto to commence closure of theanvil 28. In one embodiment, aclosure trigger sensor 205 is employed to sense when theclosure trigger 206 has been pivoted to the closed position. Theclosure trigger sensor 205 communicates with the control circuit to open thereturn valve 276 and returnvalve 278 andclose supply valve 274 to permit the pressurized fluid to return from theanvil bladder 28 into thereservoir 232. Theanvil 28 is then pivoted to the closed position by thereturn spring 23. Theclosure trigger 206 may be retained in the closed position by a releasebutton latch arrangement 36 of the type disclosed in U.S. Pat. No. 6,905,057 to Jeffrey S. Swayze and Frederick E. Shelton, IV, entitled SURGICAL STAPLING INSTRUMENT INCORPORATING A FIRING MECHANISM HAVING A LINKED RACK TRANSMISSION, the disclosure of which is herein incorporated by reference in its entirety. Another non-limiting embodiment links theclosure trigger 206 to thetube assembly 452 and causes it to move distally driving thedistal tube 410 over theend effector assembly 24 closing the system. - When the
end effector 22 is in the closed position, it may be inserted through thetrocar 490. SeeFIG. 9 . To reopen theend effector 22, therelease button 36 is pressed to unlatch theclosure trigger 206 to enable it to pivot away from the firingtrigger 208 to an open position. When in the open position, theclosure trigger sensor 205 signals thecontrol circuit 300 topower pump 230 andopen supply valve 274 andclose return valve 276. Pressurized fluid is then pumped into theanvil bladder 40 to pivot theanvil 28 to the open position. When the clinician has oriented theend effector 22 such that the desired tissue is located between theopen anvil 28 and thecartridge 60, theclosure trigger 206 is pivoted to the closed position and latched.Valves valve 241 is closed.Valves anvil bladder 40 to be returned therefrom through thelines anvil 28. Other anvil control arrangements may be employed without departing from the spirit and scope of the present invention and, therefore, the protection afforded to the various embodiments of the present invention should not be limited solely to such bladder and return spring arrangement. -
Input buttons control circuit 300 in any suitable way. In one non-limiting embodiment, eachinput button button 308 may controlvalve 272 in thecutter supply line 256. By actuating thatvalve 272, pressurized fluid supplied by thepump 230 into the manifold 242 is permitted to flow through thesupply line 256 into the cuttingbladder 102. Likewise, ifactuator button 310 is used to controlvalves button 310 will cause the staplingbladders staples 72. Multiple buttons may be selected to create firing patterns including more than one implement. In other non-limiting embodiments, eachinput button button control circuit 318 to configure the valve unit 304 such that hydraulic devices corresponding to particular surgical implements are fired when the firingtrigger 28 is depressed. It will be appreciated that various embodiments may have more or fewer input buttons than are shown. In one embodiment, a firingtrigger 208 is pivotally attached to thehandle 200 outboard of theclosure trigger 206 and one or more firing sensors (not shown) may be positioned to detect the position of the firing trigger. The firing sensors would then communicate with thecontrol circuit 300 to control the various valves to permit pressurized fluid to flow to the various staple bladders to achieve a desired firing sequence. - In various non-limiting embodiments, the
valve unit 280 may be configured to introduce a delay to the driving of one or more surgical implements included in theend effector 12. For example, it may be desirable to drive a cutting implement and then delay for a predetermined time before driving one or more zones of a stapling implement. The delay may be accomplished according to any suitable method. In one non-limiting embodiment, thecontrol circuit 300 may configure thevalve unit 280 to open a path for hydraulic fluid between thehydraulic pump 230 and a first surgical implement included in theend effector 12. When the firingtrigger 28 is actuated, the pump 302 may generate pressurized hydraulic fluid, which drives the first surgical implement. Thecontrol circuit 300 may sense when the first surgical implement is driven (e.g., by sensing the position of the firing trigger 208) and begin a timer that counts off a predetermined delay time. At the expiration of the predetermined delay time, thecontrol circuit 318 may configure thevalve unit 280 to provide the pressurized hydraulic fluid to a second surgical implement. Hydraulic pressure generated at the actuation of the firingtrigger 208 may be sufficient to drive the second surgical implement, or in various embodiments, thehydraulic pump 230 may be utilized to generate additional hydraulic pressure. - In one non-limiting embodiment of the present invention, the
end effector 22 may be attached to thehandle assembly 200 by an articulating joint assembly, generally designated as 400. As can be seen inFIGS. 1, 2 , and 12-14, the articulatingjoint assembly 400 includes adistal tube segment 410 that has adistal end 412, aproximal end 414, and a distal axis H-H. Thedistal end 412 is mechanically (e.g., rigidly or slidably connected—depending upon the anvil closure arrangement employed) coupled to theend effector body 24. Thedistal tube 410 segment may be partially hollow with the proximal end being solid with a hose/wire receiving passage 416 therethrough. - The
joint assembly 400 further includes aproximal tube segment 450, that has aproximal end 452, adistal end 454, and a proximal axis I-I. Theproximal end 452 is attached to thehandle assembly 200. In one embodiment, for example, theproximal end 452 may be attached to the handle assembly200 by an internal channel retainer that is grounded to the handle assembly. However, other fastening arrangements could be employed. In one embodiment, thedistal end 454 is solid and has a hollow hose/wire-receivingpassage 456 therethrough. The remaining portion of thetube segment 450 may be hollow to permit passage of hoses and/or wires therethrough. - In one embodiment, the
distal tube segment 410 is pivotally coupled to theproximal tube segment 450 by a balljoint assembly 460. In one embodiment, the balljoint assembly 460 comprises ahollow ball member 462 that is mounted to or formed on theproximal end 414 of thedistal tube segment 410. Theball member 462 is substantially hollow or has a hollow passageway therein to permit the passage of hoses and/or wires therethrough. Theball member 462 is received in asocket 458 provided in the distal end of theproximal tube segment 450, such that theball member 462 is free to pivot therein. - In one embodiment, an actuation assembly, generally designated as 500 is employed to articulate the
distal tube segment 410 relative to theproximal tube segment 450. As can be seen inFIGS. 11-14 , in one non-limiting embodiment, twoarticulation cylinders First articulation cylinder 510 may comprise a conventional hydraulic or pneumatic cylinder that has afirst housing 512 that contains afirst piston 514 therein. A first piston rod orfirst actuation rod 516 is attached to thefirst piston 514 and protrudes out of thefirst housing 512. Movement of thepiston 514 within thefirst housing 512 in response to the admission of pressurized fluid or air on one side or the other side of thepiston 514 causes thefirst actuation rod 516 to be extended out of thefirst cylinder housing 512 or into thefirst cylinder housing 512. Adistal end 518 of thefirst housing 512 is pivotally (pinned) or otherwise rigidly attached to theproximal end 414 of thedistal tube segment 410. Thefirst actuation rod 516 is fabricated from a flexible material such as rubber or the like and thefree end 519 thereof is rigidly affixed to thedistal end 454 of theproximal tube segment 450. Thefree end 519 of thefirst actuation rod 516 may be attached to thedistal end 454 by gluing, threads, etc. Afirst indentation 466 or a series of indentations are provided in the outer surface 464 of the ball member to provide the requisite clearance for thefirst actuation rod 516 and also the end of thefirst cylinder housing 512. - Also in this non-limiting embodiment, the
second articulation cylinder 520 may comprise a conventional hydraulic or pneumatic cylinder that has asecond housing 522 that contains asecond piston 524 therein. A second piston rod orsecond actuation rod 526 is attached to thesecond piston 526 and protrudes out of thesecond housing 522. Movement of thesecond piston 524 within thesecond cylinder housing 522 in response to the admission of pressurized fluid or air on one side or the other side of thesecond piston 524 causes theactuation rod 526 to be extended out of thesecond cylinder housing 522 or into thesecond cylinder housing 522. Thesecond cylinder housing 522 is pivotally (pinned) or otherwise rigidly attached to theproximal end 414 of thedistal tube segment 410. Thesecond actuation rod 526 is fabricated from a flexible material such as rubber or the like and thefree end 529 thereof is rigidly affixed to thedistal end 454 of theproximal tube segment 450. Thefree end 529 of thesecond actuation rod 526 may be attached to thedistal end 454 by gluing, threads, etc. Asecond indentation 468 or a series of indentations are provided in the outer surface 464 of theball member 462 to provide the requisite clearance for thesecond actuation rod 526 and also the end of thesecond cylinder housing 522. - The first and
second articulation cylinders hydraulic system 210 or they may be powered by a separate hydraulic system.FIG. 11 depicts one method of controlling the first andsecond articulation cylinders supply line 570 is connected to thesupply line 240 from thepump 230. Afirst portion 572 of thesupply line 570 is attached to a first supply port in thefirst cylinder housing 512 for supplying pressurized fluid or air into thefirst cylinder housing 512 on one side of thefirst piston 514 and asecond portion 574 of thesupply line 570 is attached to a second supply port in thefirst housing 512 for supplying pressurized fluid or air into thefirst housing 512 on the other side of thefirst piston 514. Afirst supply valve 576 is mounted in thefirst portion 572 of thesupply line 570 and a second supply valve 578 is mounted in thesecond portion 574 of thefirst supply line 570. An exhaust or returnline 580 is provided to return the pressurized fluid from thefirst housing 512 to thefluid reservoir 232. Thereturn line 580 has afirst portion 582 and asecond portion 584 attached to ports in thefirst housing 512. Afirst return valve 586 is mounted in thefirst portion 582 of thereturn line 580 and asecond return valve 588 is mounted in thesecond portion 584 of the return line. - The
supply line 570 further has athird portion 590 that is coupled to a third supply port in thesecond housing 522 on one side of thesecond piston 524 and thesupply line 570 has afourth portion 592 coupled to a fourth supply port in thesecond housing 522 on the other side of thesecond piston 524. Avalve 596 is mounted in thethird portion 590 and another valve 598 is mounted infourth portion 592 of thesupply line 570. Anotherreturn line 600 is provided to permit the pressurized fluid, air, etc. to return to thereservoir 232 from thehousing 522 during actuation of thecylinder 520. Thereturn line 600 has athird portion 602 attached to a third return port in thesecond housing 522 on one side of thesecond piston 524 and afourth portion 604 of thereturn line 600 is coupled to a fourth return port in thesecond housing 522 on the other side of thesecond piston 524. Areturn valve 606 is provided in thethird portion 602 of thereturn line 600 and anotherreturn valve 608 is provided in theportion 604 of thereturn line 600. - The valves may be controlled by the
control circuit 300 or asecond control circuit 300′ of the type described above that may include a microprocessor and other related components including Random Access Memory (RAM), Read Only Memory (ROM), etc. In other non-limiting embodiments, thecontrol circuit 300′ may include various logical circuit elements. A conventionalmultiposition switch 610 or a series of switches, push buttons etc. may be connected to thesecond control circuit 300′ for controlling thevalves cylinders - When pivotally attached together as described above, the proximal and
distal tube segments tube assembly 470 that has a passageway 472 or passageways for supporting the supply lines (collectively designated as 480) between theend effector 22 and thehandle 200. It will be appreciated that thetube assembly 470 has a circumference “C” and shape such that when thedistal tube 410 segment is coaxially aligned with theproximal tube segment 450, thetube assembly 470 may be inserted through thepassageway 492 in atrocar 490. SeeFIG. 9 . In one embodiment, the first andsecond tube segments round trocar passageway 492. The outer diameters of each thedistal tube segments trocar passageway 492 to facilitate axial insertion of thetube assembly 470 through thetrocar passage 492 and, if desired or necessary, rotation of thetube assembly 470 within thetrocar passageway 492. For example, if thetrocar passageway 492 has an inner diameter of approximately 12.8 mm (0.503 inches), the maximum outer diameter of tube assembly 470 (and of each of thetube segments 410, 450) may be approximately 12.7 mm (0.500 inches). It is conceivable that, for applications wherein the ability to rotate thetube assembly 470 within thetrocar passageway 492 is not necessary or desirable, trocars with passageways having non-circular cross-sections could be employed. In those cases, the tube assembly would have a cross-sectional shape that would facilitate axial insertion of the tube assembly through the trocar passageway and may closely resemble the cross-sectional shape of the trocar passageway. Thus, the various embodiments of the subject invention should not be limited to devices having a tube assembly with a round cross-sectional shape. -
FIG. 1 illustrates the joint assembly in a non-articulated position that would enable thetube assembly 470 to be inserted into the trocar. After the surgical implement 12 has be inserted through thetrocar 490 and it becomes desirable to articulate the implement 12, the clinician activates thecontrol circuit 300′ throughswitch 610. Depending upon the degree and direction of articulation desired, thefirst piston 516 and thesecond piston 526 may either both be extended, one extended and one retracted or both retracted to cause theball member 462 to pivot in the socket to achieve the desired amount of articulation. Thepistons control circuit 300′ to open and close thevarious control valves second actuation rods rods distal tube segment 410 to articulate relative to theproximal tube segment 450. Moreover, if thearticulation cylinders - The hydraulic control system described above for actuating the
articulation cylinders articulation cylinders ball member 462 has been described as being non-movably mounted to thedistal tube segment 410 with thesocket 458 provided in theproximal tube segment 450, those of ordinary skill in the art will understand that theball member 462 may be non-movably attached to theproximal tube segment 450 and thesocket 458 provided in thedistal tube segment 410 in other non-limiting embodiments without departing form the sprit and scope of the present invention. -
FIG. 15 illustrates another articulationjoint assembly 1400 embodiment of the present invention. As can be seen in that Figure,distal tube segment 1410 has aproximal end 1414 and a distal axis H′-H′. Although not shown inFIG. 15 , thedistal tube segment 1410 has a distal end 1412 that is mechanically coupled to theend effector body 24. Depending upon the anvil closure arrangement employed, the distal end 1412 may be non-movably attached to the end effector body or by a cable, flexible member or pivotable member. Thedistal tube 1410 segment may be partially hollow with the proximal 1414 end being solid with a hose/wire receiving passage 1416 therethrough. - The
joint assembly 1400 further includes aproximal tube segment 1450, that has adistal end 1454, and a proximal axis I′-I′. Although not shown inFIG. 15 , theproximal tube segment 1450 has a proximal end that is mechanically attached to thehandle assembly 200. - In one embodiment, the
distal tube segment 1410 is pivotally coupled to theproximal tube segment 1450 by a balljoint assembly 1460. In one embodiment, the ball joint assembly comprises ahollow ball member 1462 that is mounted to or is formed on thedistal end 1454 of theproximal tube segment 1450. Theball member 1462 has ahollow passageway 1464 that has a flared or otherwiseenlarged end portion 1465 to enable it to communicate with thepassageway 1416 such that, regardless of the position of theball member 1462, thehoses 480 and/or wires extending therethrough will not be pinched or otherwise damaged. Theball member 1462 is received in asocket 1458 provided in theproximal end 1414 of thedistal tube segment 1410, such that theball member 1462 is free to pivot or rotate therein. - In one embodiment, an actuation assembly, generally designated as 1500 is employed to articulate the
distal tube segment 1410 relative to theproximal tube segment 1450. As can be seen inFIG. 15 , in one non-limiting embodiment, twoarticulation cylinders First articulation cylinder 1510 may comprise a conventional hydraulic or pneumatic cylinder that has afirst housing 1512 that contains afirst piston 1514 therein. A first piston rod orfirst actuation rod 1516 is attached to thefirst piston 1514 and protrudes out of thefirst housing 1512. Movement of thepiston 1514 within thefirst housing 1512 in response to the admission of pressurized fluid or air on one side or the other side of thepiston 1514 causes thefirst actuation rod 1516 to be extended out of thefirst cylinder housing 1512 or into thefirst cylinder housing 1512. Adistal end 1518 of thefirst housing 1512 is pivotally (pinned) to aportion 1415 of theproximal end 1414 of thedistal tube segment 1410. The outer surface of theproximal end 1414 in the area of thefirst cylinder housing 1512 may be contoured to facilitate pivotal movement of thecylinder housing 1512. Thefirst actuation rod 1516 may be fabricated from a flexible material such as rubber or the like or it may be fabricated from rigid material. Thefree end 1519 of theactuation rod 516 is pivotally pinned to or otherwise attached to thedistal end 1454 of theproximal tube segment 1450. - Also in this non-limiting embodiment, the
second articulation cylinder 1520 may comprise a conventional hydraulic or pneumatic cylinder that has asecond housing 1522 that contains asecond piston 1524 therein. A second piston rod orsecond actuation rod 1526 is attached to thesecond piston 1524 and protrudes out of thesecond housing 1522. Movement of thesecond piston 1524 within thesecond cylinder housing 1522 in response to the admission of pressurized fluid or air on one side or the other side of thesecond piston 1524 causes theactuation rod 1526 to be extended out of thesecond cylinder housing 1522 or into thesecond cylinder housing 1522. Thedistal end 1523 of thesecond cylinder housing 1522 is pivotally (pinned) to aportion 1417 of theproximal end 1414 of thedistal tube segment 1410. The outer surface of theproximal end 1414 in the area of thesecond cylinder housing 1522 may be contoured to facilitate pivotal movement of thecylinder housing 1522. Thesecond actuation rod 1526 may be fabricated from a flexible material such as rubber or the like or it may be fabricated from rigid material. Thefree end 1529 of theactuation rod 1526 is pivotally pinned to or otherwise attached to thedistal end 1454 of theproximal tube segment 1450. - The first and
second articulation cylinders hydraulic system 210 in the same manner as was discussed in detail above with respect tocylinders FIG. 11 depicts one method of controlling the first andsecond articulation cylinders end effector 22 attached thereto) may be articulated relative to theproximal tube 1450 in the direction shown inFIG. 15 by extending theactuation rod 1526 and retracting theactuation rod 1516. Likewise, thedistal tube segment 1410 may be pivoted to a direction opposite to the direction shown inFIG. 15 by extending theactuation rod 1516 and retracting theactuation rod 1526. Thecontrol circuit 300′ may actuate thecylinders multiposition control switch 610 on thehandle assembly 200. The reader will also appreciate that, while two articulation cylinders have been described above, other embodiments of the present invention may employ only one articulation cylinder if only one degree articulation is needed or desired. Also, while theball member 1462 has been described as being non-movably mounted to theproximal tube 1450 with thesocket 1458 provided in thedistal tube segment 1410, those of ordinary skill in the art will understand that theball member 1462 may be non-movably attached to thedistal tube segment 1410 and thesocket 1458 provided in theproximal tube segment 1450 in other non-limiting embodiments without departing from the sprit and scope of the present invention. - In an alternative embodiment depicted in
FIG. 15A , thejoint assembly 1460′ comprises a round disc-like member 1462′ instead of a ball shaped member. Thedisc 1462′ has ahollow passageway 1464′ that has a flared or otherwiseenlarged end portion 1465′ to enable it to communicate with thepassageway 1416 such that, regardless of the position of the disc-like member 1462′, thehoses 480 and/or wires extending therethrough will not be pinched or otherwise damaged. The disc-like member 1462′ is received in asocket 1458′ provided in theproximal end 1414 of thedistal tube segment 1410, such that the disc-like member 1462′ is free to pivot therein. If desired, the outer edge of the disc-like member 1462′ could be provided with a tongue (not shown) that is received in a groove (not shown) in the socket wall to further stabilize the disc-like member 1462′. This embodiment otherwise employsactuators like member 1462′ has been described as being non-movably mounted to theproximal tube segment 1450 with thesocket 1458′ provided in thedistal tube segment 1410, those of ordinary skill in the art will understand that the disc-like member 1462′ may be non-movably attached to thedistal tube segment 1410 and thesocket 1458′ provided in theproximal tube segment 1450 in other non-limiting embodiments without departing from the spirit and scope of the present invention. - Another alternative embodiment is depicted in
FIG. 16 . As can be seen in this embodiment, theend 1519 of thefirst actuation rod 1516 ofcylinder 1510 is attached to portion of the outer surface of theball member 1462 and theend 1529 of thesecond actuation rod 1516 is also attached to a portion of theball member 1462. This embodiment is otherwise identical in composition and operation as the embodiment depicted inFIG. 15 and described above. Again, however, the reader will appreciate that, while two articulation cylinders have been described above, other embodiments of the present invention may employ only one articulation cylinder if only one degree articulation is needed or desired. Also, while theball member 1462 has been described as being non-movably mounted to theproximal tube segment 1450 with thesocket 1458 provided in thedistal tube segment 1410, those of ordinary skill in the art will understand that theball member 1462 may be non-movably attached to thedistal tube segment 1410 and thesocket 1458 provided in theproximal tube segment 1450 in other non-limiting embodiments without departing from the sprit and scope of the present invention. - Another alternative embodiment is depicted in
FIG. 16A . As can be seen in this embodiment, theend 1519 of thefirst actuation rod 1516 ofcylinder 1510 is attached to portion of the outer surface of the disc-like member 1462′ and theend 1529 of thesecond actuation rod 1516 is also attached to a portion of the disc-like member 1462′. This embodiment is otherwise identical in composition and operation as the embodiment depicted inFIG. 16A and described above. Again, however, the reader will appreciate that, while two articulation cylinders have been described above, other embodiments of the present invention may employ only one articulation cylinder if only one degree articulation is needed or desired. Also, while the disc-like member 1462′ has been described as being non-movably mounted to theproximal tube segment 1450 with thesocket 1458′ provided in thedistal tube segment 1410, those of ordinary skill in the art will understand that the disc-like member 1462′ may be non-movably attached to thedistal tube segment 1410 and thesocket 1458′ provided in theproximal tube segment 1450 in other non-limiting embodiments without departing from the spirit and scope of the present invention. -
FIG. 17 illustrates yet another articulationjoint assembly 2400 embodiment of the present invention. As can be seen in that Figure,distal tube segment 2410 has aproximal end 2414 and a distal axis H″-H″. Although not shown inFIG. 17 , thedistal tube segment 2410 has a distal end that is mechanically coupled to theend effector body 24. Depending upon the anvil closure arrangement employed, the distal end may be non-movably attached to eth end effector body or by a cable, flexible member or pivotable member. Thedistal tube 2410 segment may be partially hollow with theproximal end 2414 being solid with a hose/wire receiving passage 2416 therethrough. Thepassage 2416 may have a conical shapedportion 2417. - The
joint assembly 2400 further includes aproximal tube segment 2450, that has adistal end 2454, and a proximal axis I″-I″. Although not shown inFIG. 18 , theproximal tube segment 2450 has aproximal end 2454 that is attached to thehandle assembly 200. - In one embodiment, the
distal tube segment 2410 is pivotally coupled to theproximal tube segment 2450 by a balljoint assembly 2460. In one embodiment, the balljoint assembly 2460 comprises aball member 2462 that is mounted to or is formed on thedistal end 2454 of theproximal tube segment 2450. Theball member 2462 has ahollow passageway 2464 that has a flared or otherwiseenlarged end portion 2465 to enable it to communicate with thepassageway portions ball member 2462, thehoses 480 and/or wires extending therethrough will not be pinched or otherwise damaged. Theball member 2462 is received in asocket 2458 provided in theproximal end 2414 of thedistal tube segment 2410, such that theball member 2462 is free to rotate therein. - In one embodiment, an actuation assembly, generally designated as 2500 is employed to articulate the
distal tube segment 2410 relative to theproximal tube segment 2450. As can be seen inFIG. 17 , in one non-limiting embodiment, two flexibleworm gear cables worm gear cable 2510 is adapted to drivingly engage worm gear teeth, threads, etc. (not shown) within afirst gear passage 2465 formed in theball member 2462. The first flexibleworm gear cable 2510 is coupled to afirst motor 2512 that is mounted within thedistal tube segment 2410. Similarly, in this non-limiting embodiment, a second flexibleworm gear cable 2520 is adapted to drivingly engage gear teeth, threads, etc. within asecond gear passage 2467 formed in theball member 2462 that has worm gear teeth, threads, etc. 2469 formed therein. The second flexibleworm gear cable 2520 is coupled to asecond motor 2522 mounted in thedistal tube segment 2410. While described herein as “flexible worm gear cables”, it will be understood that this term is meant to encompass all types of flexible driven cable or driver arrangements that do not necessarily employ worm gear-type teeth thereon. - The first and
second motors battery 234 or another battery) or be powered by alternating current or be powered by hydraulic fluid or air. In one embodiment, themotors handle assembly 200. By controlling the amount of rotation and the direction of rotation of the first and secondworm gear cables ball member 2462 is cause to rotate within thesocket 2458 and thereby articulate the distal tube segment 2410 (and theend effector 22 attached thereto) relative to theproximal tube segment 2450. The reader will appreciate that such arrangement facilitates left articulation as shown inFIG. 17 and right articulation (not shown). Again, however, the reader will appreciate that, while two flexible worm gear cable/motor arrangements have been described above, other embodiments of the present invention may employ only one flexible worm gear cable arrangement if only one degree articulation is needed or desired. Also, while theball member 2462 has been described as being non-movably mounted to theproximal tube segment 2450 with thesocket 2458 provided in thedistal tube segment 2410, those of ordinary skill in the art will understand that theball member 2462 may be non-movably attached to thedistal tube segment 2410 and thesocket 2458 provided in theproximal tube segment 2450 in other non-limiting embodiments without departing from the sprit and scope of the present invention. - In an alternative embodiment depicted in
FIG. 17 , thejoint assembly 2460′ comprises a round disc-like member 2462′ instead of a ball shaped member. The disc-like member 2462′ has ahollow passageway 2464′ that has a flared or otherwiseenlarged end portion 2465′ to enable it to communicate with thepassageway 2416 such that, regardless of the position of the disc-like member 2462′, thehoses 480 and/or wires extending therethrough will not be pinched or otherwise damaged. The disc-like member 2462′ is received in asocket 2458′ provided in theproximal end 2414 of thedistal tube segment 2410, such that the disc-like member 2462′ is free to rotate therein. If desired, the outer edge of the disc-like member 2462′ could be provided with a tongue (not shown) that is received in a groove (not shown) in the socket wall to further stabilize the disc-like member 1462′. This embodiment otherwise employs the motor driven flexibleworm gear cables like member 2462′ has been described as being non-movably mounted to theproximal tube segment 2450 with thesocket 2458′ provided in thedistal tube segment 2410, those of ordinary skill in the art will understand that the disc-like member 2462′ may be non-movably attached to thedistal tube segment 2410 and thesocket 2458′ provided in theproximal tube segment 2450 in other non-limiting embodiments without departing from the spirit and scope of the present invention. - The various non-limiting embodiments of the present invention provide a host of advantages over prior art articulated surgical instruments. In particular, the various embodiments of the subject invention enable the portions of the tube member that attach a surgical implement to a handle to be inserted through a trocar or similar device and then be selectively articulated within the patient. While the various embodiments have been described herein in connection with use with a hydraulically operated endocutter, those of ordinary skill in the art would appreciate that the various embodiments of the subject invention could be employed with electrically powered endocutters and with a host of other types of surgical implements, regardless of whether they are electrically or hydraulically powered.
- While the present invention has been illustrated by description of several embodiments and while the illustrative embodiments have been described in considerable detail, it is not the intention of the applicant to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications may readily appear to those skilled in the art. Accordingly, the present invention has been discussed in terms of endoscopic procedures and apparatus. However, use herein of terms such as “endoscopic” should not be construed to limit the present invention to a surgical stapling and severing instrument for use only in conjunction with an endoscopic tube (i.e., trocar). On the contrary, it is believed that 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. Moreover, the various embodiment of the present invention should not be limited solely to use in connection with surgical instruments that have hydraulically powered or air powered surgical implements. The various embodiments of the present invention may also be effectively used with surgical instruments and the like that employ electrically driven surgical implements.
Claims (39)
1. A surgical instrument, comprising:
a handle assembly;
a proximal tube segment attached to said handle assembly;
a distal tube segment;
an articulating joint assembly pivotally coupling said distal tube segment to said proximal tube segment, said articulating joint assembly comprising:
a ball member non-movably coupled to an end of one of said proximal and distal tube segments and rotatably received in a corresponding socket in an end of the other of said of proximal tube segment and distal tube segment; and
an actuator assembly coupled between the ends of the distal and proximal tube segments, said actuator assembly retaining a portion of said ball member in said socket and selectively rotating said ball member portion therein to articulate said distal tube segment relative to said proximal tube segment; and
a surgical implement attached to said distal tube segment.
2. The surgical instrument of claim 1 wherein said actuator assembly comprises at least one fluid-actuated cylinder.
3. The surgical instrument of claim 2 wherein said at least one fluid-actuated cylinder comprises:
a first fluid-actuated cylinder having a first housing attached to one of said distal and proximal tube segments and a selectively extendable and retractable first actuation rod attached to the end of the other of said proximal and distal tube segments; and
a second fluid-actuated cylinder having a second housing attached to one of said distal and proximal tube segments and a selectively extendable and retractable second actuation rod attached to the end of the other of said proximal and distal tube segments.
4. The surgical instrument of claim 3 wherein said first and second actuation rods are fabricated from flexible material.
5. The surgical instrument of claim 1 wherein said ball member has at least one hollow passage therethrough adapted to communicate with openings in said distal and proximal tube segments.
6. The surgical instrument of claim 2 further comprising at least one indentation formed in an outer surface of said ball member for providing clearance for at least a portion of at least one said fluid-actuated cylinder.
7. The surgical instrument of claim 1 wherein said actuator assembly comprises at least one flexible driven member extending between said distal and proximal tube segments.
8. The surgical instrument of claim 7 wherein said at least one flexible driven member comprises a flexible worm gear cable attached to a motor and threadably engaging a corresponding passageway formed in the ball member.
9. The surgical instrument of claim 8 wherein said ball member has at least one hollow passage therethrough adapted to communicate with openings in said distal and proximal tube segments.
10. The surgical instrument of claim 1 wherein said ball member is nonmovably coupled to said end of said distal tube segment and is rotatably received in a socket in said end of said proximal tube segment.
11. The surgical instrument of claim 1 wherein said surgical implement is an endocutter.
12. The surgical instrument of claim 3 wherein said proximal tube segment defines an axis and wherein said first and second fluid-actuated cylinders are located relative to each other about said axis at an angle of substantially 180 degrees.
13. The surgical instrument of claim 3 wherein said proximal tube defines an axis and wherein said first and second fluid-actuated cylinder are located relative to each other about said axis at an angle of less than 180 degrees.
14. A surgical instrument, comprising:
a handle assembly;
a proximal tube segment attached to said handle assembly;
a distal tube segment;
an articulating joint assembly pivotally coupling said distal tube segment to said proximal tube segment, said articulating joint assembly comprising:
a ball member non-movably coupled to a distal end of end of one of said proximal and distal tube segments and rotatably received in a corresponding socket in an end of the other of said of proximal tube segment and distal tube segment; and
an actuator assembly coupled between said one of said distal and proximal tube segments that has said socket therein and said ball member to retain a portion of said ball member in said socket and selectively rotate said ball member portion therein to articulate said distal tube segment relative to said proximal tube segment; and
a surgical implement attached to said distal tube segment.
15. The surgical instrument of claim 14 wherein said actuator assembly comprises at least one fluid-actuated cylinder.
16. The surgical instrument of claim 15 wherein said at least one fluid-actuated cylinder comprises:
a first fluid-actuated cylinder having a first housing attached to said one of said distal and proximal tube segments that has said socket therein, said first fluid-actuated cylinder further comprising a selectively extendable and retractable first actuation rod attached to a portion of said ball member; and
a second fluid-actuated cylinder having a second housing attached to said one of said distal and proximal tube segments that has said socket therein, said second fluid-actuated cylinder further comprising a selectively extendable and retractable second actuation rod attached to another portion of said ball member.
17. The surgical instrument of claim 16 wherein said first and second actuation rods are fabricated from flexible material.
18. The surgical instrument of claim 14 wherein said ball member has at least one hollow passage therethrough adapted to communicate with openings in said distal and proximal tube segments.
19. The surgical instrument of claim 15 further comprising at least one indentation formed in an outer surface of said ball member for providing clearance for at least a portion of at least one said fluid-actuated cylinder.
20. The surgical instrument of claim 14 wherein said surgical implement comprises an endocutter end effector.
21. The surgical instrument of claim 16 wherein said proximal tube segment defines an axis and wherein said first and second fluid-actuated cylinders are located relative to each other about said axis at an angle of substantially 180 degrees.
22. The surgical instrument of claim 16 wherein said proximal tube defines an axis and wherein said first and second fluid-actuated cylinder are located relative to each other about said axis at an angle of less than 180 degrees.
23. A surgical instrument, comprising:
a handle assembly;
a proximal tube segment attached to said handle assembly;
a distal tube segment;
an articulating joint assembly pivotally coupling said distal tube segment to said proximal tube segment, said articulating joint assembly comprising:
a disc-like member non-movably coupled to an end of one of said proximal and distal tube segments and rotatably received in a corresponding socket in an end of the other of said of proximal tube segment and distal tube segment; and
an actuator assembly coupled between the ends of the distal and proximal tube segments, said actuator assembly retaining said disc-like member in said socket and selectively rotating said disc-like member therein to articulate said distal tube segment relative to said proximal tube segment; and
a surgical implement attached to said distal tube segment.
24. The surgical instrument of claim 23 wherein said actuator assembly comprises at least one fluid-actuated cylinder.
25. The surgical instrument of claim 24 wherein said at least one fluid-actuated cylinder comprises:
a first fluid-actuated cylinder having a first housing attached to one of said distal and proximal tube segments and a selectively extendable and retractable first actuation rod attached to the end of the other of said proximal and distal tube segments; and
a second fluid-actuated cylinder having a second housing attached to one of said distal and proximal tube segments and a selectively extendable and retractable second actuation rod attached to the end of the other of said proximal and distal tube segments.
26. The surgical instrument of claim 25 wherein said first and second actuation rods are fabricated from flexible material.
27. The surgical instrument of claim 23 wherein said disc-like member has at least one hollow passage therethrough adapted to communicate with openings in said distal and proximal tube segments.
28. The surgical instrument of claim 23 wherein said actuator assembly comprises at least one flexible driven member extending between said distal and proximal tube segments.
29. The surgical instrument of claim 28 wherein said at least one flexible driven member comprises a flexible worm gear cable attached to a motor and threadably engaging a corresponding passageway formed in the disc-like member.
30. The surgical instrument of claim 29 wherein said ball member has at least one hollow passage therethrough adapted to communicate with openings in said distal and proximal tube segments.
31. The surgical instrument of claim 23 wherein said disc-like member is nonmovably coupled to said end of said distal tube segment and is rotatably received in a socket in said end of said proximal tube segment.
32. The surgical instrument of claim 23 wherein said surgical implement is an endocutter.
33. A surgical instrument, comprising:
a handle assembly;
a proximal tube segment attached to said handle assembly;
a distal tube segment;
an articulating joint assembly pivotally coupling said distal tube segment to said proximal tube segment, said articulating joint assembly comprising:
a disc-like member non-movably coupled to an end of one of said proximal and distal tube segments and rotatably received in a corresponding socket in an end of the other of said of proximal tube segment and distal tube segment; and
an actuator assembly coupled between said one of said distal and proximal tube segments that has said socket therein and said disc-like member to retain a portion of said disc-like member in said socket and selectively rotate said disc-like member portion therein to articulate said distal tube segment relative to said proximal tube segment; and
a surgical implement attached to said distal tube segment.
34. The surgical instrument of claim 33 wherein said actuator assembly comprises at least one fluid-actuated cylinder.
35. The surgical instrument of claim 33 wherein said at least one fluid-actuated cylinder comprises:
a first fluid-actuated cylinder having a first housing attached to the one of said distal and proximal tube segments having said socket formed therein and a selectively extendable and retractable first actuation rod attached to a portion of said disc-like member; and
a second fluid-actuated cylinder having a second housing attached to the one of said distal and proximal tube segments having said socket formed therein and a selectively extendable and retractable second actuation rod attached to another portion of said disc-like member.
36. The surgical instrument of claim 35 wherein said first and second actuation rods are fabricated from flexible material.
37. The surgical instrument of claim 33 wherein said disc-like member has at least one hollow passage therethrough adapted to communicate with openings in said distal and proximal tube segments.
38. The surgical instrument of claim 33 wherein said disc-like member is nonmovably coupled to said end of said distal tube segment and is rotatably received in a socket in said end of said proximal tube segment.
39. The surgical instrument of claim 33 wherein said surgical implement is an endocutter.
Priority Applications (16)
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US11/270,866 US20070106317A1 (en) | 2005-11-09 | 2005-11-09 | Hydraulically and electrically actuated articulation joints for surgical instruments |
AU2006233260A AU2006233260B2 (en) | 2005-11-09 | 2006-10-30 | Hydraulically and electrically actuated articulation joints for surgical instruments |
MXPA06012965A MXPA06012965A (en) | 2005-11-09 | 2006-11-08 | Hydraulically and electrically actuated articulation joints for surgical instruments. |
JP2006303063A JP5274765B2 (en) | 2005-11-09 | 2006-11-08 | Hydraulic and electrical articulation joints for surgical instruments |
EP06255736A EP1785097B1 (en) | 2005-11-09 | 2006-11-08 | Hydraulically and electrically actuated articulation joints for surgical instruments |
CA2567451A CA2567451C (en) | 2005-11-09 | 2006-11-08 | Hydraulically and electrically actuated articulation joints for surgical instruments |
BRPI0604557-0A BRPI0604557A (en) | 2005-11-09 | 2006-11-09 | hydraulically and electrically actuated joint joints for surgical instruments |
CN2006101366561A CN1961839B (en) | 2005-11-09 | 2006-11-09 | Hydraulically and electrically actuated articulation joints for surgical instruments |
US12/731,347 US8858571B2 (en) | 2005-11-09 | 2010-03-25 | Hydraulically and electrically actuated articulation joints for surgical instruments |
US14/506,929 US9895147B2 (en) | 2005-11-09 | 2014-10-06 | End effectors for surgical staplers |
US14/679,470 US9968356B2 (en) | 2005-11-09 | 2015-04-06 | Surgical instrument drive systems |
US14/679,441 US10028742B2 (en) | 2005-11-09 | 2015-04-06 | Staple cartridge comprising staples with different unformed heights |
US14/679,486 US10149679B2 (en) | 2005-11-09 | 2015-04-06 | Surgical instrument comprising drive systems |
US16/020,031 US10806449B2 (en) | 2005-11-09 | 2018-06-27 | End effectors for surgical staplers |
US16/041,191 US10993713B2 (en) | 2005-11-09 | 2018-07-20 | Surgical instruments |
US17/235,177 US11793511B2 (en) | 2005-11-09 | 2021-04-20 | Surgical instruments |
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US11/270,866 US20070106317A1 (en) | 2005-11-09 | 2005-11-09 | Hydraulically and electrically actuated articulation joints for surgical instruments |
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US12/731,347 Division US8858571B2 (en) | 2005-11-09 | 2010-03-25 | Hydraulically and electrically actuated articulation joints for surgical instruments |
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US12/731,347 Active 2029-01-11 US8858571B2 (en) | 2005-11-09 | 2010-03-25 | Hydraulically and electrically actuated articulation joints for surgical instruments |
US14/506,929 Active 2027-01-24 US9895147B2 (en) | 2005-11-09 | 2014-10-06 | End effectors for surgical staplers |
US14/679,441 Active 2027-02-04 US10028742B2 (en) | 2005-11-09 | 2015-04-06 | Staple cartridge comprising staples with different unformed heights |
US14/679,470 Active 2026-12-01 US9968356B2 (en) | 2005-11-09 | 2015-04-06 | Surgical instrument drive systems |
US14/679,486 Active 2027-02-11 US10149679B2 (en) | 2005-11-09 | 2015-04-06 | Surgical instrument comprising drive systems |
US16/020,031 Active 2026-02-09 US10806449B2 (en) | 2005-11-09 | 2018-06-27 | End effectors for surgical staplers |
US16/041,191 Active 2026-02-14 US10993713B2 (en) | 2005-11-09 | 2018-07-20 | Surgical instruments |
US17/235,177 Active 2026-02-19 US11793511B2 (en) | 2005-11-09 | 2021-04-20 | Surgical instruments |
Family Applications After (8)
Application Number | Title | Priority Date | Filing Date |
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US12/731,347 Active 2029-01-11 US8858571B2 (en) | 2005-11-09 | 2010-03-25 | Hydraulically and electrically actuated articulation joints for surgical instruments |
US14/506,929 Active 2027-01-24 US9895147B2 (en) | 2005-11-09 | 2014-10-06 | End effectors for surgical staplers |
US14/679,441 Active 2027-02-04 US10028742B2 (en) | 2005-11-09 | 2015-04-06 | Staple cartridge comprising staples with different unformed heights |
US14/679,470 Active 2026-12-01 US9968356B2 (en) | 2005-11-09 | 2015-04-06 | Surgical instrument drive systems |
US14/679,486 Active 2027-02-11 US10149679B2 (en) | 2005-11-09 | 2015-04-06 | Surgical instrument comprising drive systems |
US16/020,031 Active 2026-02-09 US10806449B2 (en) | 2005-11-09 | 2018-06-27 | End effectors for surgical staplers |
US16/041,191 Active 2026-02-14 US10993713B2 (en) | 2005-11-09 | 2018-07-20 | Surgical instruments |
US17/235,177 Active 2026-02-19 US11793511B2 (en) | 2005-11-09 | 2021-04-20 | Surgical instruments |
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EP (1) | EP1785097B1 (en) |
JP (1) | JP5274765B2 (en) |
CN (1) | CN1961839B (en) |
AU (1) | AU2006233260B2 (en) |
BR (1) | BRPI0604557A (en) |
CA (1) | CA2567451C (en) |
MX (1) | MXPA06012965A (en) |
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2005
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2006
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- 2006-11-08 JP JP2006303063A patent/JP5274765B2/en active Active
- 2006-11-08 MX MXPA06012965A patent/MXPA06012965A/en not_active Application Discontinuation
- 2006-11-08 CA CA2567451A patent/CA2567451C/en not_active Expired - Fee Related
- 2006-11-08 EP EP06255736A patent/EP1785097B1/en not_active Not-in-force
- 2006-11-09 BR BRPI0604557-0A patent/BRPI0604557A/en not_active IP Right Cessation
- 2006-11-09 CN CN2006101366561A patent/CN1961839B/en not_active Expired - Fee Related
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2010
- 2010-03-25 US US12/731,347 patent/US8858571B2/en active Active
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2014
- 2014-10-06 US US14/506,929 patent/US9895147B2/en active Active
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2015
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2018
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2021
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US10149679B2 (en) | 2018-12-11 |
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CA2567451A1 (en) | 2007-05-09 |
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AU2006233260B2 (en) | 2012-02-23 |
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JP2007130471A (en) | 2007-05-31 |
US11793511B2 (en) | 2023-10-24 |
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US10993713B2 (en) | 2021-05-04 |
CA2567451C (en) | 2015-01-06 |
CN1961839B (en) | 2012-01-04 |
BRPI0604557A (en) | 2007-08-28 |
US9968356B2 (en) | 2018-05-15 |
US8858571B2 (en) | 2014-10-14 |
EP1785097A2 (en) | 2007-05-16 |
US9895147B2 (en) | 2018-02-20 |
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