US20120024099A1 - Instruments - Google Patents

Instruments Download PDF

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Publication number
US20120024099A1
US20120024099A1 US12/962,076 US96207610A US2012024099A1 US 20120024099 A1 US20120024099 A1 US 20120024099A1 US 96207610 A US96207610 A US 96207610A US 2012024099 A1 US2012024099 A1 US 2012024099A1
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United States
Prior art keywords
configuration
instrument
control
towards
move
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Abandoned
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US12/962,076
Inventor
David Main
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Surgical Innovations Ltd
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Individual
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Assigned to SURGICAL INNOVATIONS LIMITED reassignment SURGICAL INNOVATIONS LIMITED ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: MAIN, DAVID
Publication of US20120024099A1 publication Critical patent/US20120024099A1/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • A61B2017/00305Constructional details of the flexible means
    • A61B2017/00309Cut-outs or slits
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • A61B2017/00305Constructional details of the flexible means
    • A61B2017/00314Separate linked members
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • A61B2017/00318Steering mechanisms
    • A61B2017/00323Cables or rods
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2901Details of shaft
    • A61B2017/2908Multiple segments connected by articulations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/320044Blunt dissectors
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T74/00Machine element or mechanism
    • Y10T74/20Control lever and linkage systems
    • Y10T74/20006Resilient connections
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T74/00Machine element or mechanism
    • Y10T74/20Control lever and linkage systems
    • Y10T74/20207Multiple controlling elements for single controlled element

Definitions

  • the present invention relates to instruments and to surgical instruments and a method of controlling such instruments.
  • the invention is particularly applicable to endoscopic surgical instruments.
  • the present invention also relates to an instrument incorporating a tool, a method of effecting an operation including a tool, an instrument including an elongate portion and a method of operating an instrument including an elongate portion.
  • the present invention is particularly, although not exclusively relevant to instruments and methods for examining ceramic tiles on turbines.
  • a problem with inspecting ceramic tiles on turbines is that the turbine is out of commission for a long time. That is partly because of the period that it takes for the turbine to cool down and partly because of the time taken to inspect the many tiles without contacting the tiles.
  • GB 2 475 746 discloses a method for inspecting the blades of a turbine engine.
  • EP 0 623 004 discloses a surgical instrument comprising a retractor.
  • an instrument including an elongate portion having a first part movable from a first configuration to a second, different configuration and a second part, at a different elongate extent along the elongate portion than the first part, movable from a first configuration to a second, different configuration, at least one of the parts including a control whereby a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration.
  • an instrument including an elongate portion having:
  • a second part at a different elongate extend along the elongate portion than the first part movable from a first to a second, different configuration
  • at least one of the parts including a control, said control including a flexible member arranged to exert a bias against movement of the part that includes that control from the first to the second position, said control operating such that
  • a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration and such that
  • the second part is arranged to start to move from the second configuration towards the first configuration at a greater force than the force required to allow the first part to start to move from the second configuration towards the first configuration
  • the instrument further including an actuator, said actuator being arranged to urge said first and second parts from the first to the second positions, the actuator comprising at least one wire extending along the elongate portion which wire extends along the elongate portion which wire is arranged to be tightened to effect movement of the parts from the first to the second configurations.
  • a method of using an instrument comprising causing at least first and second parts of an elongate portion that are axially spaced from each other along the elongate portion to move from a first configuration to a second, different configuration and causing the first part to move from the first configuration towards the second configuration and then the second part to start to move from the first configuration towards the second configuration by the first part being less resistant to a force causing movement from the first configuration to the second configuration than a force causing the second part to move from the first configuration towards the second configuration.
  • FIG. 1 is a side view of a surgical instrument comprising a surgical retractor 1 with an end 2 in a straight configuration;
  • FIG. 2 is a view of the end 2 of the retractor shown in FIG. 1 in a straight hook configuration
  • FIG. 3 is a view of an end 2 of a retractor similar to that shown in FIG. 1 in an angled hook configuration;
  • FIG. 4 is a schematic perspective view of one of the segments 3 at the end 2 of the retractor shown in FIG. 1 ;
  • FIG. 5 is a front view of a first embodiment of a retractor
  • FIG. 6 is a front view of a second embodiment of a retractor
  • FIG. 7 is a perspective view of a third embodiment of a retractor
  • FIG. 8 is a side view of a turbine 10 that is to be inspected
  • FIGS. 9 to 13 are sectional views along the line A-A of FIG. 8 from the initial insertion configuration of an instrument to a configuration in which the instrument finally ends up in for the inspection;
  • FIG. 14 is a perspective of the instrument
  • FIG. 15 is a side view of a pair of segments 114 of the instrument.
  • FIG. 16 is a side view of the pair of segments 114 in a configuration for inspection
  • FIG. 17 is an end view of a segment 114 ;
  • FIG. 18 is a plan view of a segment 114 ;
  • FIG. 19 is a side view of the segments in the final, inspection position
  • FIG. 20 is a side view of the camera
  • FIGS. 21 a - i are sequential views showing how the configuration of FIG. 7 is formed when the wire 10 is pulled;
  • FIGS. 22 a - i are sequential views showing how the configuration of FIG. 7 is formed when the wire 10 is pulled when using control members;
  • FIG. 23 is a longitudinal cross-section of the instrument that can form the shape of FIG. 7 and FIG. 24 is a detail of that figure;
  • FIG. 25 is a longitudinal cross sectional view of part of the instrument showing the wire 10 and the control member and FIG. 26 is cross-section 22 - 26 of FIG. 25 , and
  • FIGS. 27 a, b, c, d and e are sequential views showing hot an inspection instrument such as that shown in FIGS. 8 to 20 can be manipulated when using the control members.
  • FIG. 1 shows a retractor 1 having a handle 6 which is connected to the end 2 via a hollow rod 7 .
  • the end 2 and part of the rod 7 are fed through a tube in the abdominal wall.
  • the surgeon is then able to manipulate the retractor by the handle 6 and change the configuration of the end 2 into the straight hook shape shown in FIG. 2 by rotating a knurled actuating nut 8 .
  • the nut 8 is threadably connected to a screw member 9 whereby, when the nut 8 is rotated in a clockwise direction, looking from the free end of the handle, the screw member 9 is caused to move translationally away from the end 2 .
  • a loop of wire 10 is connected at its free ends to the member 9 , and both sides of the loop pass through openings 11 in each segment 3 . Accordingly as the wire 10 moves further into the rod 7 the segments are caused to tighten against each other.
  • each segment 3 bear against each other they are caused to move out of the axial extent of the rod as the end faces 12 of each segment are formed at a slight angle to the perpendicular to the axis of the rod.
  • the upwardly facing surfaces of each segment are parallel with each other as are the downwardly facing surfaces. Accordingly adjacent faces come into abutment with each other as the wire is tightened, and they take up the configuration shown in FIG. 2 in which a straight, substantially rigid hook which subtends approximately 180° is formed. Accordingly in the position shown in FIG. 1 , each face extends at an angle of approximately 10° to the axis of the tube.
  • the face of at least one of the segments is angled differently.
  • the uppermost segment faces the rod with a face extending at 45° to the axis of the rod, and the rod may be correspondingly angled at its end.
  • the segment adjacent to the rod is caused to turn through 90°.
  • the remaining upper and lower faces of the other segments may be parallel to each other in the configuration shown in FIG. 1 as previously described.
  • the hooks shown in FIGS. 2 and 3 can be used to displace or hold the organs in the required position.
  • the nut 8 is rotated in the opposite direction to release the tension in the wire.
  • the wire is sufficiently strong, and the distance between the segments sufficiently small for the flexure of the wire to hold the segments generally straight for ease of insertion or removal when the hook configuration is not required.
  • the strength of the wire and the close proximity of the segments prevents any significant relative turning of the segments around the longitudinal extent of the end 2 .
  • each segment which is caused to abut against another part of the retractor when in the hook configuration is formed with styrations 13 which are parallel to each other and parallel to adjacent styrations such that co-operating faces do not tend to slip in a rotational or translational sense.
  • the remote end includes an exposed end 20 .
  • this end can cause trauma to the body, particularly the liver.
  • Such flexure causes the end section to have a reduced effect on pushing the liver.
  • an instrument such as a surgical instrument for example, includes an elongate portion arranged, in use, to be inserted through a restricted opening into a body, the elongate portion being movable from a first configuration to a second, different configuration in which second configuration two parts of the instrument that are spaced from each other in the first configuration at least partially cross each other in second configuration.
  • the parts may contact each other in the second configuration.
  • the parts may completely cross each other in the second configuration and may completely cross each other such that the instrument extends over itself.
  • One of the parts may comprise an end region.
  • the parts may comprise parts that are spaced from the end region.
  • the end region may include a portion that is movable to extend up towards the location where the parts cross and down from the location where the parts cross.
  • the instrument may include a rigid portion, which rigid portion comprises at least one of the parts that at least partially cross each other and a plurality of parts that cross each other may include the rigid portion.
  • the instrument In the first configuration, the instrument extends in a common first direction and in which, in the second configuration part of the instrument extends in a second direction which is opposed to the first direction and in the second direction, the one part of the instrument may be caused to extend back towards another part.
  • two spaced elongate extents of the instruments may both extend at an angle to the first direction.
  • the instrument may include spaced joint regions that enable the instrument to move from the first to the second configuration and the spaced joint regions may allow the instrument to cross itself at least twice in the second configuration.
  • the joint regions may comprise a plurality of segments movable relative to each other to assist in causing the movement from the first to the second configurations.
  • the instrument may include first control means arranged to cause the movement from the first to the second configuration.
  • the two parts may be biased towards each other at the region where they at least partially cross each other.
  • the instrument may include a flexible member extending outside of the instrument from the end region to a location spaced from the end region and the flexible member may be arranged to assist in effecting movement from the first to the second configuration and the flexible member may be arranged to be tensioned, initially, as movement from the first configuration commences and subsequently to be slackened.
  • the instrument may include second control means arranged to control the operation of the flexible member. The first and second control means may be arranged to be coordinated to effect the movement from the first to the second configurations.
  • one previously spaced part of the instrument may be arranged to be connected to another part of the instrument and one part may comprise the end portion of the instrument.
  • the connection may be arranged to be by means of a plug and socket.
  • the flexible member may be arranged to extend within the instrument and then out of the instrument in the region of where the parts are arranged to be connected and then to extend externally of the instrument to the other part that is to be connected whereby tensioning the flexible member is arranged to assist in effecting the connection.
  • a method of controlling a surgical instrument comprises causing an elongate portion to move from a first configuration in which two parts are spaced from each other to a second configuration in which those parts at least partially cross each other.
  • the method may comprise causing the instrument to move to a second configuration in which the instrument crosses itself twice.
  • the present invention also includes a method of controlling an instrument when the instrument is as herein described.
  • an instrument includes an elongate portion movable from a first configuration to a second, different configuration, the instrument including a channel extending at least partially along the elongate extent of the instrument and a tool located at least partially in the channel, the tool being arranged to effect an operation at least one side of the instrument.
  • the operation may be arranged to be effected at more than one side.
  • the operation may be arranged to be effected at a location spaced from the distal end.
  • the operation may be arranged to be effected at a plurality of locations along the instrument and the tool may be arranged to be moved along the channel to effect an operation at a plurality of locations and the tool may be arranged to be advanced to effect an operation at a plurality of locations and the tool may be arranged to be retracted to effect an operation at a plurality of locations.
  • the instrument may include a control arranged to move the tool along the channel and to effect the operation.
  • the window may comprise an opening and the tool may be arranged to extend at least partially through the opening in the instrument to effect the operation and the extent of the tool through the opening may be variable.
  • the tool may be arranged to project beyond the opening and the orientation of the distal region of the tool may be is adjustable when extending at least partially through the opening.
  • At least the second configuration of the tool may be predetermined and the elongate extent of the elongate portion may be moved to the second configuration upon activation of a control member.
  • the instrument may comprise a turbine inspection instrument.
  • the tool may comprise a camera.
  • a method of effecting an operation comprises altering the configuration of an elongate portion from a first configuration to a second configuration and effecting an operation at least one side of the elongate portion with a tool located at least partly in a channel of the elongate portion.
  • the tool may be moved along the channel to effect the operation at different elongate extents.
  • the tool may be moved to extend at least partially through an opening in the elongate portion to effect the operation.
  • a method of effecting an operation includes effecting that operation with an instrument as herein referred to.
  • a surgical instrument includes an elongate portion arranged, in use, to be inserted through a restricted opening into a body, the elongate portion being movable from a first configuration to a second, different configuration in which second configuration two parts of the instrument that are spaced from each other in the first configuration at least partially cross each other in second configuration.
  • a method of controlling a surgical instrument comprises causing an elongate portion to move from a first configuration in which two parts are spaced from each other to a second configuration in which those parts at least partially cross each other.
  • the present invention also includes a method of performing surgery when using the instrument of the present invention or when controlling the instrument of the present invention.
  • the first configuration may be a straight configuration.
  • an instrument includes an elongate portion movable from a first configuration to a second, different configuration, the instrument including a channel extending at least partially along the elongate extent of the instrument and a tool located at least partially in the channel, the tool being arranged to effect an operation at least one side of the instrument.
  • a method of effecting an operation comprises altering the configuration of an elongate portion from a first configuration to a second configuration and effecting an operation at least one side of the elongate portion with a tool located at least partly in a channel of the elongate portion.
  • an instrument includes an elongate portion movable from a first configuration to a second, different configuration, the instrument including an operative member attached to the elongate portion at a first location and including an extent external to the elongate portion, the operative member, in use, being arranged to exert a force on the elongate portion to at least partially assist in causing the elongate portion to move at least part of the way between the first and second configurations.
  • a method of operating an instrument includes an elongate portion and an operative member attached to the elongate portion, the operative member including an extent external to the elongate portion the method comprising exerting a force on the elongate portion thereby causing the elongate portion to move from the first configuration to a second, different configuration.
  • an instrument includes an elongate portion movable from a first configuration to a second, different configuration, the elongate portion comprising a plurality of segments that are connected to each other by a connection means and that are movable relative to each other whereby the elongate portion can move from the first to the second configuration, the connection means comprising at least one pivot member acting as a hinge between the segments.
  • a method of connecting a plurality of segments of an elongate instrument such that the segments can move from a first configuration to a second, different configuration comprises using a pivot member to act as a hinge between the segments.
  • an instrument including an elongate portion having a first part movable from a first configuration to a second, different configuration and a second part, at a different elongate extent along the elongate portion than the first part, movable from a first configuration to a second, different configuration, at least one of the parts including a control whereby a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration.
  • Both ends of the control are arranged to slide in the longitudinal direction relative to the portions of the elongate member which are coaxial with each end when the part that controls the moves from the first configuration towards the second configuration.
  • At least one end of at least one control may be prevented from sliding in the longitudinal direction relative to a portion of the elongate member which is coaxial with that end when the part that includes that control is moved from the first to the second configuration.
  • the end that is prevented from sliding may be connected to the elongate portion at the location of the elongate portion that is coaxial with that end.
  • At least one control may be capable of moving in the longitudinal direction of the elongate portion relative to the elongate portion when the part associated with that control is in the foot configuration and at least one end region of the control may cooperate with the elongate portion to restrict movement in at least one or both directions of the elongate extract.
  • At least one control may be located within the periphery of the elongate portion and may be in a central region of the control.
  • At least one control may be made of metal.
  • An actuator may be arranged to urge the first and second parts from the first and second positions at the same time and, when the first and second parts are in the foot configuration may be arranged to an equal bias on the paste to urge them away from the first configuration.
  • each retractor is able to have a straight configuration to enable the retractor to be inserted or removed and only the second configurations are shown in which each adjacent segment abuts each other to inhibit further bending.
  • FIG. 5 there are four segments 3 adjacent to the hollow rod 7 and four at each of the further corners.
  • Long segments 22 and 24 extend between the short segments and a longer segment 26 has its tip 20 extending back under the rod 7 .
  • the tip 20 should be concealed in the view shown by the hollow rod.
  • FIG. 6 has the same general shape of that of FIG. 5 .
  • the shaft 7 includes a further control cable 28 that is connected to the tip 30 of the elongate portion. The cable exits the shaft 7 just short of the first series of segments.
  • control cable 28 is tensioned to draw the tip 30 towards the shaft 7 .
  • a recess 32 may be provided in the shaft 7 in which the tip 30 may be drawn into and held by the cable.
  • This configuration allows greater force to be applied with less trauma being provided than that of FIG. 5 .
  • the retractor can be urged in either direction to equal advantage as the configuration is symmetrical from the front and back.
  • the long segments 40 and 42 are connected by angled faces that allow the segment 40 to be inclined upwardly as it extends towards the rod with the segment 42 being inclined downwardly as it extends away from the rod 7 .
  • the movement of the segments 40 and 42 can be coordinated to take place as the end of the instrument moves back over the shaft towards the segment 34 .
  • the segments 40 and 42 may be fixed together to form an angled suit such that they can not move relative to each other.
  • the segments 40 and 42 may be urged against the long segment 32 and the short segments 3 adjacent to the rod 7 as the segments 40 and 42 are being moved into place such that relative flexure of those parts occurs.
  • FIG. 7 affords stability and strength in either direction. Furthermore trauma is reduced because of the considerable cross sectional area provided by the retractor or both sides of the shaft 7 .
  • the end segment 42 may be connected to the shaft 7 by a control cable.
  • the control cable may be tensioned to assist in the retractor leaving the straight configuration. As the wires tension the segments and as the retractor takes up the shape shown the cable may be tensioned or relaxed to assist in the shape being taken up.
  • the instrument could be other than a retractor or may, for instance, have a tool operating from the end such as a cutter or a gripper of a suture.
  • the turbine 110 includes an inner core 118 in the form of a trumpet and an outer fairing 120 .
  • the surfaces of the core and fairing that face each other include ceramic tiles 122 that are subject to extreme heat.
  • the fairing 120 is provided with a series of entry ports 124 .
  • the instrument 112 is inserted through one of the ports 24 in a straight configuration, as shown in FIG. 9 with the instrument being threaded through a short tube 126 of the control 116 .
  • the upper, proximal end of the instrument includes a tube 128 that slides through the control tube 126 and projects a short distance from the control tube.
  • a line 130 extends along the outside of the instrument from the bottom of the tube 128 to the distal, end segment 114 n as shown in detail in FIG. 19 . This line 130 assists in the instrument taking up its shape. The line 130 is then tensioned to bring the instrument into the shape shown in FIG. 10 . It will be appreciated that the turbines can have a diameter of 4 m and consequently the instruments can have a considerable weight.
  • the line 130 places the instrument in a position at which a control wire 132 , to be described later, can turn adjacent segments relative to each other with a good mechanical advantage.
  • control wire 132 that connects each segments it then tightened and, at the same time or before or after or with an overlap of control of the line 130 and the wire 132 , the line 130 is released slightly so that the instrument reaches the position shown in FIG. 11 . In this position the segments 114 c and 114 d are in their final relative position.
  • the line 130 and the control wire 132 may be coordinated to ensure that the instrument does not touch the tiles such that, for instance, without the use of the line 130 the instrument would inevitably touch the tiles.
  • each segment includes a pair of spaced projecting flanges 136 and the other a central flange 138 .
  • the central flange 138 is located between spaced flanges 136 of an adjacent segment and the pin 134 extends through aligned openings 140 in the flanges 136 , 138 .
  • the combined extent of the flanges 136 and the flange 138 is 1 ⁇ 3 of the maximum width of the segment. However, that combined extent may be more than 10 or more than 20 or more than 30 or more than 40% or less than 90 or less than 80 or less than 70% of the maximum width.
  • Elongate spaced holes 142 extend down each side of the segments.
  • the control wire 132 extends down one of the inclined holes 142 in adjacent segments, around the end segment and then back through the other holes.
  • the holes 142 are spaced from the pins 134 . Consequently tension of the control wire 132 causes relative rotation of adjacent segments about the pins 134 until adjacent planar faces 144 abut each other, as shown in FIG. 16 .
  • each side of each segment includes an elongate opening 146 .
  • the exterior cross-section is circular
  • the interior cross-section is thicker at the lower portion where the hinges are located and where the maximum forces will be experienced than at the top portion with the thickness decreasing from a lower region, then to the side middle regions to the thinnest top region.
  • each segment includes an elongate opening 148 at the top and bottom.
  • the segments provide a clear operating corridor 150 along the complete length of the instrument.
  • a flexible cord 152 having a camera 154 at the distal tip can be located in the corridor.
  • the tip of the cord 152 having the camera can be bent by a camera operator at the control 116 to extend out through the opposed elongate openings 148 in each segment.
  • the tiles 122 on both the inner core 118 and fairing 120 are able to be viewed for damage such as cracks, for instance. Damaged tiles can be replaced. Viewing may be manual or may be automated.
  • the present invention is not restricted to the inspection of damaged tiles and the interior of any machine could be inspected by an inspection member, which may not necessarily be a camera, inspecting through the side of a carrier.
  • the camera 152 may be located at the distal region of the segments when the instrument is inserted into the turbine and pulled back under tension.
  • the camera 154 may be inserted into the segments after they have taken up the inspection configuration shown in FIGS. 13 and 19 in which case the inspection can take place as the camera advances or, alternatively, the camera can be inserted to the end of the instrument and then pulled back to make the sequence of inspections.
  • the cord can then be indexed, either by retraction from the corridor or by advancement through the corridor with the camera being alternately extended through each opening 148 of each segment.
  • the camera may be advanced at different distances from different openings. Furthermore, the camera, once through an opening 148 , can view at least partially rearwardly, at least partially forwardly or at least partially to at least one side or any combination thereof, possibly by further manipulation of the camera once through the opening.
  • the control 116 comprises a housing 156 shown in FIG. 19 that is clamped to one of the entry ports 124 . At the same time, or subsequently, a housing may be clamped to the other entry ports 124 . In this way the complete periphery of the tiles is visible.
  • the control tube 124 that is fast with the housing extends both into the turbine and upwardly beyond the housing at an angle to the perpendicular of the surface that the housing is attached to.
  • the line 130 is controlled by a winding reel 158 .
  • the control wires are tensioned or slackened by a hollow threaded member 160 .
  • the cord 152 of the camera is fed through the hollow threaded member 160 .
  • the manipulation of the camera tip is well known and is effected by pulling articulation cables 162 shown in FIG. 20 to cause the tip to move from a straight position to a curved position as indicated by the arrow 164 .
  • Fibre optic cables within the cord 152 carry the images of the camera to a control.
  • the control may include actuators that control the operation of the line 130 , the control wire 132 and the location of the cord 152 and operating the camera 154 .
  • the control may automatically sequence the operation of any one or more of the actuators.
  • FIGS. 21 a - i are sequential views showing how the configuration of FIG. 7 is formed when the wire 10 is pulled.
  • the first part of the instrument that bends is the proximal part between the rod 7 and the long segment 32 that changes shape from FIGS. 21 a to 21 b to 21 c .
  • the short segments 3 abut each other to prevent further rotation at that location the adjacent short segments then cause the shape to change from FIGS. 21 c to 21 d .
  • further tightening causes turning of the instrument to progress towards the proximal end possibly with abutment of distally located segment prior to adjacent proximal segments commencing to turn or possibly with a partial turn of distal segments prior to adjacent proximal segments commencing to turn.
  • FIGS. 22 a to i start and finish with the same configuration as that of FIGS. 21 a and 21 i when the wire 10 is progressively tightened. However the turning sequence is controlled. When the instrument is in the position shown in FIG. 22 a , the force exerted on all segments urging them from the in line position may be equal.
  • the first turn occurs at the distal end with the short segments 3 between the long segments 40 and 38 moving from the configuration of FIGS. 22 a to 22 d .
  • the segments 3 between the long segment 38 and the long segment 36 start to turn to change the configuration from that of FIGS. 22 d to 22 e .
  • those segments 3 may abut each other or before they abut each other the adjacent distal segments start to turn.
  • Such progressive successive turning of adjacent distal segments continues until the configuration of FIG. 22 i is arrived at.
  • FIGS. 22 a to 22 i involve only sweeping a very small area.
  • This control is advantageous when using the instrument as a surgical instrument and when using the instrument as a tool such as that described in relation to FIGS. 8 to 20 .
  • looking at FIG. 14 it may be that adjacent proximal segments could be caused to turn first rather than adjacent distal segments.
  • FIGS. 23 to 26 show how the control is applied. Long segments 34 , 36 , 38 and 40 are shown as in FIG. 7 . However there may be a different number of short segments.
  • FIGS. 23 and 24 the wire 10 that is pulled to turn the segments is not shown.
  • a control member 200 is connected, through the segments 3 and the long segments 38 and 40 , to the distal end 40 . Further control members 202 extend from the long segment 36 , through the segments 3 , to the long segment 34 .
  • control members 200 and 202 When the wire 10 is tightened to cause turning of the segments the control members 200 and 202 must also turn thus affording resistance to the turning (and also in due course assisting in the return of the segments to the configuration shown).
  • the member 200 may be of the same material and/or may be of a slightly smaller diameter than each of the members 202 . Accordingly the members 202 afford greater resistance to turning and the distal segments between the long segments 36 and 40 will start to turn first.
  • Only one end of the members 202 is shown. They are provided at each end with enlarged heads 204 . This stops the members 202 from moving out of the segments that they control. It also allows for the members to be straight and curved without the heads abutting the segments to restrict turning as the distance between the heads at each end is greater than the distance that they occupy when the segments are at their limit of turning. Abutment of the segments may limit the extent of a turn. Alternatively or additionally abutment of the heads 204 at each end of one or both members 202 with segments at the end of a portion that is being controlled may limit the extent of a turn.
  • control members comprise spring steel or a memory metal such as NiTiNoL which may comprise Ni:Ti 50:50 Nickel Titanium alloy. Whilst the members 200 and 202 are shown as being of the same or similar diameter and material they may be of different material. Alternatively they may be of different cross sectional dimensions such as of different diameters. Alternatively the members 202 may be connected along their length.
  • FIGS. 25 and 26 show the location of the wire 10 and the control member 200 .
  • the resistance of the control member or members 200 , 202 , 204 and 206 progressively increases.
  • the control members could be arranged in an order such that 200 affords the greatest resistance, then 204, then 202 and then 206. In this manner the sequence of movement of any bendable member can be controlled.
  • FIGS. 27 a to e show an inspection instrument 300 having three regions 302 , 304 and 306 each of which can be curved or straight.
  • the instrument includes a tool 308 at the distal end that is required to inspect material external members 310 and 312 of a machine 314 .
  • the resistance of control members is weakest through the region 302 , greater at region 304 and greatest at region 306 . Accordingly tensioning the wire 10 (not shown) allows a right angle turn to be effected at the region 302 , as shown in FIG. 27 b with the distal end of the instrument then being inserted through an opening 34 of the machine.
  • control members could be applied to FIGS. 1 to 3 .
  • a control member 200 affording low resistance could be located through segments at the distal region, causing that region to turn first, with a stiffer control member 202 extending through segments at a proximal region.
  • control member 200 may afford less resistance than the control member 202 .
  • control of the segments shown in FIGS. 9 to 20 could be effected by locating different resistance control members along different lengths to enable maneuvering of the instrument in the tight space easier and/or to allow the appropriate parts to be accessed and inspected by the control members causing the required sequential movement on tightening or releasing the wire or wires that move the segments.

Abstract

An instrument including an elongate portion having a first part movable from a first configuration to a second, different configuration and a second part, at a different elongate extent along the elongate portion than the first part, movable from a first configuration to a second, different configuration, at least one of the parts including a control whereby a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration. A method of using the instrument.

Description

    CROSS-REFERENCE TO RELATED APPLICATION
  • This Application claims priority to GB 1003516.0 filed Mar. 3, 2010 and entitled “INSTRUMENTS”, the contents of which are incorporated by reference herein.
  • TECHNICAL FIELD AND BACKGROUND OF THE INVENTION
  • The present invention relates to instruments and to surgical instruments and a method of controlling such instruments. The invention is particularly applicable to endoscopic surgical instruments.
  • The present invention also relates to an instrument incorporating a tool, a method of effecting an operation including a tool, an instrument including an elongate portion and a method of operating an instrument including an elongate portion.
  • The present invention is particularly, although not exclusively relevant to instruments and methods for examining ceramic tiles on turbines.
  • A problem with inspecting ceramic tiles on turbines is that the turbine is out of commission for a long time. That is partly because of the period that it takes for the turbine to cool down and partly because of the time taken to inspect the many tiles without contacting the tiles.
  • GB 2 475 746 discloses a method for inspecting the blades of a turbine engine.
  • EP 0 623 004 discloses a surgical instrument comprising a retractor.
  • It is an object of the present invention to attempt to overcome at least one of the above or other disadvantages.
  • BRIEF SUMMARY OF THE INVENTION
  • According to one aspect of the present invention an instrument including an elongate portion having a first part movable from a first configuration to a second, different configuration and a second part, at a different elongate extent along the elongate portion than the first part, movable from a first configuration to a second, different configuration, at least one of the parts including a control whereby a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration.
  • According to another aspect of the present invention an instrument including an elongate portion having:
  • a first part movable from a first to a second different configuration and
  • a second part at a different elongate extend along the elongate portion than the first part movable from a first to a second, different configuration, at least one of the parts including a control, said control including a flexible member arranged to exert a bias against movement of the part that includes that control from the first to the second position, said control operating such that
  • a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration and such that
  • the second part is arranged to start to move from the second configuration towards the first configuration at a greater force than the force required to allow the first part to start to move from the second configuration towards the first configuration,
  • the instrument further including an actuator, said actuator being arranged to urge said first and second parts from the first to the second positions, the actuator comprising at least one wire extending along the elongate portion which wire extends along the elongate portion which wire is arranged to be tightened to effect movement of the parts from the first to the second configurations.
  • According to a further aspect of the present invention a method of using an instrument comprising causing at least first and second parts of an elongate portion that are axially spaced from each other along the elongate portion to move from a first configuration to a second, different configuration and causing the first part to move from the first configuration towards the second configuration and then the second part to start to move from the first configuration towards the second configuration by the first part being less resistant to a force causing movement from the first configuration to the second configuration than a force causing the second part to move from the first configuration towards the second configuration.
  • DESCRIPTION OF THE FIGURES
  • FIG. 1 is a side view of a surgical instrument comprising a surgical retractor 1 with an end 2 in a straight configuration;
  • FIG. 2 is a view of the end 2 of the retractor shown in FIG. 1 in a straight hook configuration;
  • FIG. 3 is a view of an end 2 of a retractor similar to that shown in FIG. 1 in an angled hook configuration;
  • FIG. 4 is a schematic perspective view of one of the segments 3 at the end 2 of the retractor shown in FIG. 1;
  • FIG. 5 is a front view of a first embodiment of a retractor;
  • FIG. 6 is a front view of a second embodiment of a retractor;
  • FIG. 7 is a perspective view of a third embodiment of a retractor;
  • FIG. 8 is a side view of a turbine 10 that is to be inspected;
  • FIGS. 9 to 13 are sectional views along the line A-A of FIG. 8 from the initial insertion configuration of an instrument to a configuration in which the instrument finally ends up in for the inspection;
  • FIG. 14 is a perspective of the instrument;
  • FIG. 15 is a side view of a pair of segments 114 of the instrument;
  • FIG. 16 is a side view of the pair of segments 114 in a configuration for inspection;
  • FIG. 17 is an end view of a segment 114;
  • FIG. 18 is a plan view of a segment 114;
  • FIG. 19 is a side view of the segments in the final, inspection position;
  • FIG. 20 is a side view of the camera;
  • FIGS. 21 a-i are sequential views showing how the configuration of FIG. 7 is formed when the wire 10 is pulled;
  • FIGS. 22 a-i are sequential views showing how the configuration of FIG. 7 is formed when the wire 10 is pulled when using control members;
  • FIG. 23 is a longitudinal cross-section of the instrument that can form the shape of FIG. 7 and FIG. 24 is a detail of that figure;
  • FIG. 25 is a longitudinal cross sectional view of part of the instrument showing the wire 10 and the control member and FIG. 26 is cross-section 22-26 of FIG. 25, and
  • FIGS. 27 a, b, c, d and e are sequential views showing hot an inspection instrument such as that shown in FIGS. 8 to 20 can be manipulated when using the control members.
  • DETAILED DESCRIPTION OF THE INVENTION
  • FIG. 1 shows a retractor 1 having a handle 6 which is connected to the end 2 via a hollow rod 7. In use, with the end in the configuration shown in the drawing, the end 2 and part of the rod 7 are fed through a tube in the abdominal wall. The surgeon is then able to manipulate the retractor by the handle 6 and change the configuration of the end 2 into the straight hook shape shown in FIG. 2 by rotating a knurled actuating nut 8.
  • The nut 8 is threadably connected to a screw member 9 whereby, when the nut 8 is rotated in a clockwise direction, looking from the free end of the handle, the screw member 9 is caused to move translationally away from the end 2. A loop of wire 10 is connected at its free ends to the member 9, and both sides of the loop pass through openings 11 in each segment 3. Accordingly as the wire 10 moves further into the rod 7 the segments are caused to tighten against each other.
  • As the segments 3 bear against each other they are caused to move out of the axial extent of the rod as the end faces 12 of each segment are formed at a slight angle to the perpendicular to the axis of the rod. In FIG. 1 the upwardly facing surfaces of each segment are parallel with each other as are the downwardly facing surfaces. Accordingly adjacent faces come into abutment with each other as the wire is tightened, and they take up the configuration shown in FIG. 2 in which a straight, substantially rigid hook which subtends approximately 180° is formed. Accordingly in the position shown in FIG. 1, each face extends at an angle of approximately 10° to the axis of the tube.
  • In order for the segments to take up the shape shown in FIG. 3, in which a substantially rigid hook which subtends approximately 180° in a direction generally at right angles to the axis of the rod, the face of at least one of the segments is angled differently. For instance, when the end 2 is in the relaxed position and extends generally in line with the axis of the rod 7, the uppermost segment faces the rod with a face extending at 45° to the axis of the rod, and the rod may be correspondingly angled at its end. Thus when the wire is tightened, the segment adjacent to the rod is caused to turn through 90°. The remaining upper and lower faces of the other segments may be parallel to each other in the configuration shown in FIG. 1 as previously described.
  • The hooks shown in FIGS. 2 and 3 can be used to displace or hold the organs in the required position.
  • To release the segments from the configuration shown in FIG. 2 or 3 the nut 8 is rotated in the opposite direction to release the tension in the wire. The wire is sufficiently strong, and the distance between the segments sufficiently small for the flexure of the wire to hold the segments generally straight for ease of insertion or removal when the hook configuration is not required. As the wire is threaded through two openings in each segment the strength of the wire and the close proximity of the segments prevents any significant relative turning of the segments around the longitudinal extent of the end 2.
  • The face of each segment which is caused to abut against another part of the retractor when in the hook configuration is formed with styrations 13 which are parallel to each other and parallel to adjacent styrations such that co-operating faces do not tend to slip in a rotational or translational sense.
  • With such retractors the remote end includes an exposed end 20. When pushing tissue aside this end can cause trauma to the body, particularly the liver. In addition there is inevitably some flexure in the segments. Such flexure causes the end section to have a reduced effect on pushing the liver.
  • Furthermore, whilst it is relatively easy to achieve the configuration shown it can be difficult to effect more complicated configurations.
  • It is an object of the present invention to attempt to overcome at least one of the above or other disadvantages.
  • According to one aspect of the present invention, an instrument, such as a surgical instrument for example, includes an elongate portion arranged, in use, to be inserted through a restricted opening into a body, the elongate portion being movable from a first configuration to a second, different configuration in which second configuration two parts of the instrument that are spaced from each other in the first configuration at least partially cross each other in second configuration.
  • The parts may contact each other in the second configuration.
  • The parts may completely cross each other in the second configuration and may completely cross each other such that the instrument extends over itself.
  • One of the parts may comprise an end region.
  • The parts may comprise parts that are spaced from the end region.
  • There may be at least two pairs of parts that are spaced from each other in the first configuration and at least partially cross each other, at different extents for the pairs, along the instrument in the second configuration, and going along the elongate extent of the instrument, the first pair may cross on one side of the instrument with the second pair also crossing on that side. There may be at least three pairs of parts that are spaced from each other in the first configuration and that at least partially cross each other at different extents, for the pairs, along the instrument in the second configuration and, going along the extent of the instrument, the first and second pairs may cross on the same side with the third pair crossing on the opposite side.
  • The end region may include a portion that is movable to extend up towards the location where the parts cross and down from the location where the parts cross.
  • The instrument may include a rigid portion, which rigid portion comprises at least one of the parts that at least partially cross each other and a plurality of parts that cross each other may include the rigid portion.
  • In the first configuration, the instrument extends in a common first direction and in which, in the second configuration part of the instrument extends in a second direction which is opposed to the first direction and in the second direction, the one part of the instrument may be caused to extend back towards another part. In the second configuration two spaced elongate extents of the instruments may both extend at an angle to the first direction.
  • The instrument may include spaced joint regions that enable the instrument to move from the first to the second configuration and the spaced joint regions may allow the instrument to cross itself at least twice in the second configuration. The joint regions may comprise a plurality of segments movable relative to each other to assist in causing the movement from the first to the second configurations.
  • The instrument may include first control means arranged to cause the movement from the first to the second configuration.
  • In the second configuration, the two parts may be biased towards each other at the region where they at least partially cross each other.
  • The instrument may include a flexible member extending outside of the instrument from the end region to a location spaced from the end region and the flexible member may be arranged to assist in effecting movement from the first to the second configuration and the flexible member may be arranged to be tensioned, initially, as movement from the first configuration commences and subsequently to be slackened. The instrument may include second control means arranged to control the operation of the flexible member. The first and second control means may be arranged to be coordinated to effect the movement from the first to the second configurations.
  • In the second configuration, one previously spaced part of the instrument may be arranged to be connected to another part of the instrument and one part may comprise the end portion of the instrument. The connection may be arranged to be by means of a plug and socket. The flexible member may be arranged to extend within the instrument and then out of the instrument in the region of where the parts are arranged to be connected and then to extend externally of the instrument to the other part that is to be connected whereby tensioning the flexible member is arranged to assist in effecting the connection.
  • According to another aspect of the present invention a method of controlling a surgical instrument comprises causing an elongate portion to move from a first configuration in which two parts are spaced from each other to a second configuration in which those parts at least partially cross each other.
  • The method may comprise causing the instrument to move to a second configuration in which the instrument crosses itself twice.
  • The present invention also includes a method of controlling an instrument when the instrument is as herein described.
  • According to a further aspect of the present invention an instrument includes an elongate portion movable from a first configuration to a second, different configuration, the instrument including a channel extending at least partially along the elongate extent of the instrument and a tool located at least partially in the channel, the tool being arranged to effect an operation at least one side of the instrument.
  • The operation may be arranged to be effected at more than one side.
  • The operation may be arranged to be effected at a location spaced from the distal end.
  • The operation may be arranged to be effected at a plurality of locations along the instrument and the tool may be arranged to be moved along the channel to effect an operation at a plurality of locations and the tool may be arranged to be advanced to effect an operation at a plurality of locations and the tool may be arranged to be retracted to effect an operation at a plurality of locations. The instrument may include a control arranged to move the tool along the channel and to effect the operation.
  • The window may comprise an opening and the tool may be arranged to extend at least partially through the opening in the instrument to effect the operation and the extent of the tool through the opening may be variable. The tool may be arranged to project beyond the opening and the orientation of the distal region of the tool may be is adjustable when extending at least partially through the opening.
  • At least the second configuration of the tool may be predetermined and the elongate extent of the elongate portion may be moved to the second configuration upon activation of a control member.
  • The instrument may comprise a turbine inspection instrument.
  • The tool may comprise a camera.
  • According to a further aspect of the present invention, a method of effecting an operation comprises altering the configuration of an elongate portion from a first configuration to a second configuration and effecting an operation at least one side of the elongate portion with a tool located at least partly in a channel of the elongate portion.
  • The tool may be moved along the channel to effect the operation at different elongate extents.
  • The tool may be moved to extend at least partially through an opening in the elongate portion to effect the operation.
  • According to another aspect of the present invention a method of effecting an operation includes effecting that operation with an instrument as herein referred to.
  • According to one aspect of the present invention a surgical instrument includes an elongate portion arranged, in use, to be inserted through a restricted opening into a body, the elongate portion being movable from a first configuration to a second, different configuration in which second configuration two parts of the instrument that are spaced from each other in the first configuration at least partially cross each other in second configuration.
  • According to a further aspect of the present invention a method of controlling a surgical instrument comprises causing an elongate portion to move from a first configuration in which two parts are spaced from each other to a second configuration in which those parts at least partially cross each other.
  • The present invention also includes a method of performing surgery when using the instrument of the present invention or when controlling the instrument of the present invention.
  • The first configuration may be a straight configuration.
  • According to one aspect of the present invention an instrument includes an elongate portion movable from a first configuration to a second, different configuration, the instrument including a channel extending at least partially along the elongate extent of the instrument and a tool located at least partially in the channel, the tool being arranged to effect an operation at least one side of the instrument.
  • According to another aspect of the present invention a method of effecting an operation comprises altering the configuration of an elongate portion from a first configuration to a second configuration and effecting an operation at least one side of the elongate portion with a tool located at least partly in a channel of the elongate portion.
  • According to a further aspect of the present invention an instrument includes an elongate portion movable from a first configuration to a second, different configuration, the instrument including an operative member attached to the elongate portion at a first location and including an extent external to the elongate portion, the operative member, in use, being arranged to exert a force on the elongate portion to at least partially assist in causing the elongate portion to move at least part of the way between the first and second configurations.
  • According to a still further aspect of the present invention a method of operating an instrument includes an elongate portion and an operative member attached to the elongate portion, the operative member including an extent external to the elongate portion the method comprising exerting a force on the elongate portion thereby causing the elongate portion to move from the first configuration to a second, different configuration.
  • According to another aspect of the present invention an instrument includes an elongate portion movable from a first configuration to a second, different configuration, the elongate portion comprising a plurality of segments that are connected to each other by a connection means and that are movable relative to each other whereby the elongate portion can move from the first to the second configuration, the connection means comprising at least one pivot member acting as a hinge between the segments.
  • According to a further aspect of the present invention a method of connecting a plurality of segments of an elongate instrument such that the segments can move from a first configuration to a second, different configuration comprises using a pivot member to act as a hinge between the segments.
  • According to another aspect of the present invention an instrument including an elongate portion having a first part movable from a first configuration to a second, different configuration and a second part, at a different elongate extent along the elongate portion than the first part, movable from a first configuration to a second, different configuration, at least one of the parts including a control whereby a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration.
  • Both ends of the control are arranged to slide in the longitudinal direction relative to the portions of the elongate member which are coaxial with each end when the part that controls the moves from the first configuration towards the second configuration.
  • At least one end of at least one control may be prevented from sliding in the longitudinal direction relative to a portion of the elongate member which is coaxial with that end when the part that includes that control is moved from the first to the second configuration. The end that is prevented from sliding may be connected to the elongate portion at the location of the elongate portion that is coaxial with that end.
  • At least one control may be capable of moving in the longitudinal direction of the elongate portion relative to the elongate portion when the part associated with that control is in the foot configuration and at least one end region of the control may cooperate with the elongate portion to restrict movement in at least one or both directions of the elongate extract.
  • At least one control may be located within the periphery of the elongate portion and may be in a central region of the control.
  • At least one control may be made of metal.
  • An actuator may be arranged to urge the first and second parts from the first and second positions at the same time and, when the first and second parts are in the foot configuration may be arranged to an equal bias on the paste to urge them away from the first configuration.
  • Any of the aspects of the invention may be combined.
  • Each of the embodiments of the retractors shown may be operated as described in relation to FIGS. 1 to 4. Accordingly only the differences will be described. In addition, each retractor is able to have a straight configuration to enable the retractor to be inserted or removed and only the second configurations are shown in which each adjacent segment abuts each other to inhibit further bending.
  • In FIG. 5 there are four segments 3 adjacent to the hollow rod 7 and four at each of the further corners. Long segments 22 and 24 extend between the short segments and a longer segment 26 has its tip 20 extending back under the rod 7. Ideally the tip 20 should be concealed in the view shown by the hollow rod.
  • This arrangement has advantages over the segmental arrangements shown in FIGS. 2 and 3 in that no twisting of the retractor about the shaft 7 occurs if the retractor is urged in a direction out of the plane shown or into the plane shown. In addition at least part of the tip 20 is concealed by the rod 7 or can trail the rod 7 thus effecting less trauma.
  • FIG. 6 has the same general shape of that of FIG. 5. However the shaft 7 includes a further control cable 28 that is connected to the tip 30 of the elongate portion. The cable exits the shaft 7 just short of the first series of segments.
  • In use, either before the segments are tensioned by the wires 10 to take up the configuration shown, or after, or during at least part of that tensioning or any combination thereof the control cable 28 is tensioned to draw the tip 30 towards the shaft 7. A recess 32 may be provided in the shaft 7 in which the tip 30 may be drawn into and held by the cable.
  • This configuration allows greater force to be applied with less trauma being provided than that of FIG. 5. In addition the retractor can be urged in either direction to equal advantage as the configuration is symmetrical from the front and back.
  • Whilst the angles that the short segment of FIGS. 5 and 6 allow the retractor to turn are approximately 45°. 135° and 135° respectively the embodiment of FIG. 7 is more complicated.
  • In FIG. 7, starting from the rod 7, four short segments 3 allow the next long segment 32 to extend at 90° to the extent of the rod. Then six short segments 3 cause an even longer segment 34 to extend back towards the rod 7 at an angle of 45° to the rod. Then two short segments cause the “shortest” long segment 36 to cross over the rod 7, possibly in contact therewith, before two further short segments cause a further turn of 45° for the next long segment 38. Then eight short segments 3 cause a further turn of 180°. This brings two long segments 40 and 42 back over the rod 7 with the end of the segment 42 being tucked under the long segment 34.
  • The long segments 40 and 42 are connected by angled faces that allow the segment 40 to be inclined upwardly as it extends towards the rod with the segment 42 being inclined downwardly as it extends away from the rod 7. The movement of the segments 40 and 42 can be coordinated to take place as the end of the instrument moves back over the shaft towards the segment 34. Alternatively the segments 40 and 42 may be fixed together to form an angled suit such that they can not move relative to each other. The segments 40 and 42 may be urged against the long segment 32 and the short segments 3 adjacent to the rod 7 as the segments 40 and 42 are being moved into place such that relative flexure of those parts occurs. When the joint between the segments 40 and 42 pass the segments 3 adjacent to the rod they spring back to allow the segment 42 to pass beneath the segment 34 and to maintain the shape shown under flexure with those parts crossing the rod being urged against the rod. Furthermore, that binding force may also cause the segment 36 to be biased. The biasing forces may be assisted by the angled slope of the segment 42 sliding along the segment 34 and pushing further against the segment 34 as the segment 42 slides further beneath the segment 34.
  • The configuration of FIG. 7 affords stability and strength in either direction. Furthermore trauma is reduced because of the considerable cross sectional area provided by the retractor or both sides of the shaft 7.
  • Although not shown in the drawing of FIG. 7, the end segment 42 may be connected to the shaft 7 by a control cable. The control cable may be tensioned to assist in the retractor leaving the straight configuration. As the wires tension the segments and as the retractor takes up the shape shown the cable may be tensioned or relaxed to assist in the shape being taken up.
  • As the retractor crosses the rigid rod in FIGS. 5 and 7 (and as the retractor is fixed in FIG. 6) when the rod is urged towards a liver with the cross parts being located between the rod and liver a rigid retractor is provided with a broad area of even force being applied.
  • Whilst the above described instruments are retractors it will be appreciated that the instrument could be other than a retractor or may, for instance, have a tool operating from the end such as a cutter or a gripper of a suture.
  • As shown in FIGS. 8 and 9, the turbine 110 includes an inner core 118 in the form of a trumpet and an outer fairing 120. The surfaces of the core and fairing that face each other include ceramic tiles 122 that are subject to extreme heat.
  • The fairing 120 is provided with a series of entry ports 124.
  • In use, the instrument 112 is inserted through one of the ports 24 in a straight configuration, as shown in FIG. 9 with the instrument being threaded through a short tube 126 of the control 116.
  • The upper, proximal end of the instrument includes a tube 128 that slides through the control tube 126 and projects a short distance from the control tube. A line 130 extends along the outside of the instrument from the bottom of the tube 128 to the distal, end segment 114 n as shown in detail in FIG. 19. This line 130 assists in the instrument taking up its shape. The line 130 is then tensioned to bring the instrument into the shape shown in FIG. 10. It will be appreciated that the turbines can have a diameter of 4 m and consequently the instruments can have a considerable weight. The line 130 places the instrument in a position at which a control wire 132, to be described later, can turn adjacent segments relative to each other with a good mechanical advantage.
  • In the position shown in FIG. 10 adjacent segments 114 d, 114 e and 114 f are brought into their final relative positions by the tension of the line 130.
  • The control wire 132 that connects each segments it then tightened and, at the same time or before or after or with an overlap of control of the line 130 and the wire 132, the line 130 is released slightly so that the instrument reaches the position shown in FIG. 11. In this position the segments 114 c and 114 d are in their final relative position.
  • From the position shown in FIG. 11 the line 130 is released further and the wire 132 is further tightened in the way described above in relation to the movement from FIGS. 10 to 11 to reach the position shown in FIG. 12. In this configuration the adjacent segments 114 a to 114 i are all in their final relative configuration.
  • Further tensioning of the control wire 132 and the slackening of the line 130 in the way described in relation to the movement from FIGS. 10 to 114 leaves the instrument in the final configuration shown in FIGS. 13 and 19. In this position the line 130 is slack and each adjacent segment abuts each other and are unable to turn further. In addition the segment 114 a has turned relative to the instrument tube 128 such that further relative turning is prevented.
  • The line 130 and the control wire 132 may be coordinated to ensure that the instrument does not touch the tiles such that, for instance, without the use of the line 130 the instrument would inevitably touch the tiles.
  • Thus a rigid instrument is provided. The operation of the instrument will be described later.
  • The segments will now be described in greater detail. It will be appreciated that not all segments need be the same length. Indeed it can be seen in FIGS. 9 to 13 that the segments 14 a to 14 e are half the length of the remaining segments.
  • As shown in FIGS. 15 to 17 adjacent segments are connected together by a pin 134. One end of each segment includes a pair of spaced projecting flanges 136 and the other a central flange 138. The central flange 138 is located between spaced flanges 136 of an adjacent segment and the pin 134 extends through aligned openings 140 in the flanges 136,138. The combined extent of the flanges 136 and the flange 138 is ⅓ of the maximum width of the segment. However, that combined extent may be more than 10 or more than 20 or more than 30 or more than 40% or less than 90 or less than 80 or less than 70% of the maximum width.
  • Elongate spaced holes 142 extend down each side of the segments. The control wire 132 extends down one of the inclined holes 142 in adjacent segments, around the end segment and then back through the other holes. The holes 142 are spaced from the pins 134. Consequently tension of the control wire 132 causes relative rotation of adjacent segments about the pins 134 until adjacent planar faces 144 abut each other, as shown in FIG. 16.
  • For weight reduction each side of each segment includes an elongate opening 146. Furthermore, as shown in FIG. 17, whilst the exterior cross-section is circular the interior cross-section is thicker at the lower portion where the hinges are located and where the maximum forces will be experienced than at the top portion with the thickness decreasing from a lower region, then to the side middle regions to the thinnest top region.
  • As shown in FIG. 18, each segment includes an elongate opening 148 at the top and bottom.
  • It can be seen from FIG. 17 in particular that the segments provide a clear operating corridor 150 along the complete length of the instrument. A flexible cord 152 having a camera 154 at the distal tip can be located in the corridor. The tip of the cord 152 having the camera can be bent by a camera operator at the control 116 to extend out through the opposed elongate openings 148 in each segment. In this way the tiles 122 on both the inner core 118 and fairing 120 are able to be viewed for damage such as cracks, for instance. Damaged tiles can be replaced. Viewing may be manual or may be automated.
  • It will be appreciated that the present invention is not restricted to the inspection of damaged tiles and the interior of any machine could be inspected by an inspection member, which may not necessarily be a camera, inspecting through the side of a carrier.
  • The camera 152 may be located at the distal region of the segments when the instrument is inserted into the turbine and pulled back under tension. Alternatively the camera 154 may be inserted into the segments after they have taken up the inspection configuration shown in FIGS. 13 and 19 in which case the inspection can take place as the camera advances or, alternatively, the camera can be inserted to the end of the instrument and then pulled back to make the sequence of inspections.
  • The cord can then be indexed, either by retraction from the corridor or by advancement through the corridor with the camera being alternately extended through each opening 148 of each segment.
  • It will be appreciated that the camera may be advanced at different distances from different openings. Furthermore, the camera, once through an opening 148, can view at least partially rearwardly, at least partially forwardly or at least partially to at least one side or any combination thereof, possibly by further manipulation of the camera once through the opening.
  • The control 116 comprises a housing 156 shown in FIG. 19 that is clamped to one of the entry ports 124. At the same time, or subsequently, a housing may be clamped to the other entry ports 124. In this way the complete periphery of the tiles is visible.
  • The control tube 124 that is fast with the housing extends both into the turbine and upwardly beyond the housing at an angle to the perpendicular of the surface that the housing is attached to.
  • As shown in FIG. 19 the line 130 is controlled by a winding reel 158. The control wires are tensioned or slackened by a hollow threaded member 160. The cord 152 of the camera is fed through the hollow threaded member 160.
  • The manipulation of the camera tip is well known and is effected by pulling articulation cables 162 shown in FIG. 20 to cause the tip to move from a straight position to a curved position as indicated by the arrow 164. Fibre optic cables within the cord 152 carry the images of the camera to a control.
  • The control may include actuators that control the operation of the line 130, the control wire 132 and the location of the cord 152 and operating the camera 154. The control may automatically sequence the operation of any one or more of the actuators.
  • FIGS. 21 a-i are sequential views showing how the configuration of FIG. 7 is formed when the wire 10 is pulled. The first part of the instrument that bends is the proximal part between the rod 7 and the long segment 32 that changes shape from FIGS. 21 a to 21 b to 21 c. When the short segments 3 abut each other to prevent further rotation at that location the adjacent short segments then cause the shape to change from FIGS. 21 c to 21 d. It can be seen that further tightening causes turning of the instrument to progress towards the proximal end possibly with abutment of distally located segment prior to adjacent proximal segments commencing to turn or possibly with a partial turn of distal segments prior to adjacent proximal segments commencing to turn.
  • It can be seen though that there is no control over how and when each segment commences to turn. Further, there is a large sweep when moving from FIGS. 21 a to 21 i, for instance, which may not be acceptable when using the instrument as a surgical retractor or when using the instrument as a tool to cooperate with a machine such as an application as described in relation to FIGS. 8 to 20.
  • FIGS. 22 a to i start and finish with the same configuration as that of FIGS. 21 a and 21 i when the wire 10 is progressively tightened. However the turning sequence is controlled. When the instrument is in the position shown in FIG. 22 a, the force exerted on all segments urging them from the in line position may be equal.
  • The first turn occurs at the distal end with the short segments 3 between the long segments 40 and 38 moving from the configuration of FIGS. 22 a to 22 d. When those segments 3 but each other or before abutment occurs the segments 3 between the long segment 38 and the long segment 36 start to turn to change the configuration from that of FIGS. 22 d to 22 e. Again when those segments 3 may abut each other or before they abut each other the adjacent distal segments start to turn. Such progressive successive turning of adjacent distal segments continues until the configuration of FIG. 22 i is arrived at.
  • It can be seen that the change from FIGS. 22 a to 22 i involves only sweeping a very small area. This control is advantageous when using the instrument as a surgical instrument and when using the instrument as a tool such as that described in relation to FIGS. 8 to 20. For instance looking at FIG. 14 it may be that adjacent proximal segments could be caused to turn first rather than adjacent distal segments.
  • FIGS. 23 to 26 show how the control is applied. Long segments 34, 36, 38 and 40 are shown as in FIG. 7. However there may be a different number of short segments.
  • In FIGS. 23 and 24 the wire 10 that is pulled to turn the segments is not shown.
  • A control member 200 is connected, through the segments 3 and the long segments 38 and 40, to the distal end 40. Further control members 202 extend from the long segment 36, through the segments 3, to the long segment 34.
  • When the wire 10 is tightened to cause turning of the segments the control members 200 and 202 must also turn thus affording resistance to the turning (and also in due course assisting in the return of the segments to the configuration shown). The member 200 may be of the same material and/or may be of a slightly smaller diameter than each of the members 202. Accordingly the members 202 afford greater resistance to turning and the distal segments between the long segments 36 and 40 will start to turn first.
  • Either when all of the segments with the member 200 extending therethrough abut each other or shortly before that, the segments 3 with the members 202 extending through them will start to turn, overcoming the resistance afforded by the members 202.
  • Only one end of the members 202 is shown. They are provided at each end with enlarged heads 204. This stops the members 202 from moving out of the segments that they control. It also allows for the members to be straight and curved without the heads abutting the segments to restrict turning as the distance between the heads at each end is greater than the distance that they occupy when the segments are at their limit of turning. Abutment of the segments may limit the extent of a turn. Alternatively or additionally abutment of the heads 204 at each end of one or both members 202 with segments at the end of a portion that is being controlled may limit the extent of a turn.
  • The control members comprise spring steel or a memory metal such as NiTiNoL which may comprise Ni:Ti 50:50 Nickel Titanium alloy. Whilst the members 200 and 202 are shown as being of the same or similar diameter and material they may be of different material. Alternatively they may be of different cross sectional dimensions such as of different diameters. Alternatively the members 202 may be connected along their length.
  • FIGS. 25 and 26 show the location of the wire 10 and the control member 200.
  • Referring back now to FIGS. 22 a to g, the resistance of the control member or members 200, 202, 204 and 206 progressively increases. However, if desired, the control members could be arranged in an order such that 200 affords the greatest resistance, then 204, then 202 and then 206. In this manner the sequence of movement of any bendable member can be controlled.
  • FIGS. 27 a to e show an inspection instrument 300 having three regions 302, 304 and 306 each of which can be curved or straight. The instrument includes a tool 308 at the distal end that is required to inspect material external members 310 and 312 of a machine 314. The resistance of control members is weakest through the region 302, greater at region 304 and greatest at region 306. Accordingly tensioning the wire 10 (not shown) allows a right angle turn to be effected at the region 302, as shown in FIG. 27 b with the distal end of the instrument then being inserted through an opening 34 of the machine. Further tensioning then causes the region 304 to move through 90°, opposite to the first turn, to allow the wall 310 to be inspected before final tensioning causes the region 306 to move through 90°, opposite to the previous turn, to allow the wall 312 to be inspected as shown in FIG. 27 e.
  • Removal of the instrument is a reverse of that sequence with the control members ensuring that first region 306 is straightened, then region 304 and finally region 306.
  • The control members could be applied to FIGS. 1 to 3. For instance a control member 200 affording low resistance could be located through segments at the distal region, causing that region to turn first, with a stiffer control member 202 extending through segments at a proximal region.
  • Similarly in FIGS. 5 and 6, the control member 200 may afford less resistance than the control member 202.
  • Likewise control of the segments shown in FIGS. 9 to 20 could be effected by locating different resistance control members along different lengths to enable maneuvering of the instrument in the tight space easier and/or to allow the appropriate parts to be accessed and inspected by the control members causing the required sequential movement on tightening or releasing the wire or wires that move the segments.
  • Attention is directed to all papers and documents which are filed concurrently with or previous to this specification in connection with this application and which are open to public inspection with this specification, and the contents of all such papers and documents are incorporated herein by reference.
  • All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), and/or all of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at least some of such features and/or steps are mutually exclusive.
  • Each feature disclosed in this specification (including any accompanying claims, abstract and drawings) may be replaced by alternative features serving the same, equivalent or similar purpose, unless expressly stated otherwise. Thus, unless expressly stated otherwise, each feature disclosed is one example only of a generic series of equivalent or similar features.
  • The invention is not restricted to the details of the foregoing embodiment(s). The invention extends to any novel one, or any novel combination, of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or to any novel one, or any novel combination, of the steps of any method or process so disclosed.

Claims (20)

1. An instrument including an elongate portion having a first part movable from a first configuration to a second, different configuration and a second part, at a different elongate extent along the elongate portion than the first part, movable from a first configuration to a second, different configuration, at least one of the parts including a control whereby a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration.
2. An instrument as claimed in claim 1 in which at least one control includes a flexible member arranged to exert a bias against movement of the part that includes that control from the first to the second position.
3. An instrument as claimed in claim 1 in which at least one end of at least one control is arranged to slide in the longitudinal direction relative to a portion of the elongate member which is coaxial to that end when the part that includes that control is moved from the first configuration towards the second configuration.
4. An instrument as claimed in claim 3 in which at least one end of at least one control is prevented from sliding in the longitudinal direction relative to a portion of the elongate member which is coaxial with that end when the part that includes that control is moved from the first configuration towards the second configuration and in which the end that is prevented from sliding is connected to the elongate portion at the location of the elongate portion that is coaxial with that end.
5. An instrument as claimed in claim 1 in which at least one control is capable of moving in the longitudinal direction of the elongate portion relative to the elongate portion when the part associated with that control is in the first configuration and in which at least one end region of the control cooperates with the elongate portion to restrict movement of the control in both directions of the elongate extent.
6. An instrument as claimed in claim 5 in which the distance between the end regions of the control that restrict sliding movement of the control is arranged such that they do not simultaneously cooperate with the elongate portion when the part that includes that control is moved from the first towards the second configuration.
7. An instrument as claimed in claim 5 in which the distance between the end regions of the control co-operate with the elongate portion when the part that includes that control moves to the second configuration whereby the distance between the end regions defines the limit of movement from the first configuration to the second configuration.
8. An instrument as claimed in claim 1 in which each part includes a control whereby the force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration.
9. An instrument as claimed in claim 1 in which the or each control is arranged to assist in returning the first and second parts from the second configuration towards the first configuration.
10. An instrument as claimed in claim 9 in which the second part is arranged to start to move from the second configuration towards the first configuration at a greater force than the force required to allow the first part to start to move from the second configuration towards the first configuration.
11. An instrument as claimed in claim 1 in which the elongate portion includes at least three parts at different elongate extents along the elongate portion each movable from a first to a second, different configuration each having a control in which a force required to move the parts from the first towards the second configuration is different in the at least three parts.
12. An instrument as claimed in claim 1 including an actuator arranged to urge the first and second parts from the first to the second positions, the actuator comprising at least one wire extending along the elongate portion which wire is arranged to be tightened to effect movement from the first to the second configuration.
13. An instrument as claimed in claim 12 in which the actuator is arranged to urge the first and second parts from the first to the second configuration at the same time and, when the first and second parts are in the first configuration, to exert an equal bias on the parts to urge them away from the first configuration.
14. An instrument as claimed in claim 1 in which at least the first part includes at least a gap along a side of the elongate portion which gap, in use, is arranged to be at least partially closed when the first part is moved from the first towards the second configuration.
15. An instrument as claimed in claim 14 in which the or each gap of that part is arranged to be at least partially closed before the second part starts to move from the first towards the second configuration.
16. An instrument as claimed in claim 15 in which the or each gap of the first part is arranged to be completely closed before the second part starts to move from the first towards the second configuration.
17. An instrument as claimed in claim 14 in which the or each gap is defined between two, separate segments.
18. An instrument including an elongate portion comprising:
a first part movable from a first configuration to a second, different configuration; and
a second part at a different elongate extend along the elongate portion than the first part movable from a first to a second, different configuration, at least one of the parts including a control, said control including a flexible member arranged to exert a bias against movement of the part that includes that control from the first to the second position, said control operating such that a force required to move the first part from the first configuration towards the second configuration is less than the force required to move the second part from the first configuration towards the second configuration and such that the second part is arranged to start to move from the second configuration towards the first configuration at a greater force than the force required to allow the first part to start to move from the second configuration towards the first configuration;
the instrument further including an actuator, said actuator being arranged to urge said first and second parts from the first to the second positions, the actuator comprising at least one wire extending along the elongate portion which wire extends along the elongate portion which wire is arranged to be tightened to effect movement of the parts from the first to the second configurations.
19. A method of using an instrument comprising causing at least first and second parts of an elongate portion that are axially spaced from each other along the elongate portion to move from a first configuration to a second, different configuration and causing the first part to move from the first configuration towards the second configuration and then the second part to start to move from the first configuration towards the second configuration by the first part being less resistant to a force causing movement from the first configuration to the second configuration than a force causing the second part to move from the first configuration towards the second configuration.
20. A method claimed in claim 19 comprising, when the first and second parts are in the second configuration, reducing the force simultaneously on each part holding them in that configuration and causing the control in at least one part to cause the second part to start to move from the second configuration towards the first configuration before the first part starts to move from the second configuration towards the first configuration.
US12/962,076 2010-03-03 2010-12-07 Instruments Abandoned US20120024099A1 (en)

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EP2542161A1 (en) 2013-01-09
GB2477867A (en) 2011-08-17
GB201003516D0 (en) 2010-04-21
US20130035554A1 (en) 2013-02-07
CN102781342A (en) 2012-11-14
GB2477867B (en) 2012-03-14
GB2477867A8 (en) 2011-10-05
WO2011107800A1 (en) 2011-09-09
US9232936B2 (en) 2016-01-12
BR112012022190A2 (en) 2016-07-05
GB201103545D0 (en) 2011-04-13

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