U.S. patent application number 11/349769 was filed with the patent office on 2006-12-21 for laparoscopic surgical instrument for in situ tool exchange.
Invention is credited to Alfred Perlin.
Application Number | 20060287641 11/349769 |
Document ID | / |
Family ID | 37574389 |
Filed Date | 2006-12-21 |
United States Patent
Application |
20060287641 |
Kind Code |
A1 |
Perlin; Alfred |
December 21, 2006 |
Laparoscopic surgical instrument for in situ tool exchange
Abstract
A method is presented for replacing a tool through a sleeve of a
laparoscopic instrument without removing the sleeve from a body.
The method includes rotating a housing portion of the laparoscopic
instrument to expose an end of a first tool to be removed, removing
the first tool from the sleeve, and inserting a second tool into
the sleeve without removing it from the body.
Inventors: |
Perlin; Alfred; (Highland
Park, IL) |
Correspondence
Address: |
Justin D. Swindells;JENKENS & GILCHRIST, A PROFESSIONAL CORPORATION
Suite 2600
225 West Washington
Chicago
IL
60606-3418
US
|
Family ID: |
37574389 |
Appl. No.: |
11/349769 |
Filed: |
February 7, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60690968 |
Jun 16, 2005 |
|
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|
60711347 |
Aug 25, 2005 |
|
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Current U.S.
Class: |
606/1 |
Current CPC
Class: |
A61B 2017/00464
20130101; A61B 17/29 20130101; A61B 2017/292 20130101; A61B
2017/0046 20130101; A61B 2017/2947 20130101; A61B 2017/291
20130101; A61B 2017/2946 20130101 |
Class at
Publication: |
606/001 |
International
Class: |
A61B 17/00 20060101
A61B017/00 |
Claims
1. A method of replacing a tool from a sleeve of a laparoscopic
instrument without removing the sleeve from a body, comprising:
rotating a housing assembly of the laparoscopic instrument to
expose an end of the tool to be removed; removing the tool from the
sleeve of the laparoscopic instrument without removing the sleeve
from the body; and inserting a second tool into the laparoscopic
instrument.
2. The method of claim 1, further comprising registering the
exposed end of the tool in at least one of a ball-receiving slot
and a ball-receiving hole of the housing portion when the housing
assembly portion is in a locked position.
3. The method of claim 2, wherein the ball-receiving slot is
included in a housing of the housing assembly.
4. The method of claim 2, wherein the ball-receiving hole is
included in a drum of the housing assembly.
5. The method of claim 1, pressing a locking lever to unlock the
housing assembly from a locked position.
6. The method of claim 1, wherein the rotating includes rotating
the housing portion about an axis of the laparoscopic instrument
selected from a group consisting of an X-axis, a Y-axis, and a
Z-axis, wherein the X-axis is any axis lying in the 3-dimensional
space occupied by the laparoscopic instrument.
7. The method of claim 1, wherein the rotating includes rotating
the housing assembly about a hinge of the laparoscopic instrument,
the housing assembly being pivotably coupled to the hinge via a
hinge pin.
8. The method of claim 1, further comprising grasping a pair of
handles when rotating the housing assembly, the pair of handles
being attached to the housing assembly.
9. The method of claim 1, further comprising linearly displacing
the tool when the housing assembly is in a locked position to
manipulate a tool device located at an opposing end of the
tool.
10. A laparoscopic instrument comprising: a housing assembly
including a pair of handles; and a hinge portion pivotally
connected to the housing portion and including a tool knob
extension for insertion into an incision of a body, the knob
extension having an open end and an elongated hollow shaft for
receiving a first tool for insertion into the hollow shaft through
the open end, the hinge portion being pivotable between a closed
position and an open position, the hinge portion being positioned
in the open position with the knob extension remaining in the body
when changing the first tool with a second tool.
11. The laparoscopic instrument of claim 10, wherein the housing
assembly includes a drum assembly having at least two drums
connected to respective ones of the pair of handles, the drums
rotating independently of one another to permit movement of the
handles relative to one another, the drums also rotating together
in a fixed relationship about an axis passing through the center of
the drums to permit rotation of the handles in a fixed relationship
about the axis.
12. The laparoscopic instrument of claim 10, wherein the. hinge in
the closed position rotates around an axis perpendicular to an axis
of the knob extension to achieve the open position.
13. The laparoscopic instrument of claim 10, wherein the hinge
portion in the closed position rotates around an axis parallel to
an axis of the knob extension to achieve the open position.
14. The laparoscopic instrument of claim 10, wherein the hinge
portion further includes a locking lever for locking the hinge
portion in at least the locked position and the open position.
15. The laparoscopic instrument of claim 10, wherein the housing
assembly includes a ball-receiving slot for receiving a ball end of
any of the first tool and the second tool when the hinge portion is
in the closed position.
16. A method of replacing a tool of a laparoscopic instrument,
comprising: inserting a laparoscopic instrument into an incision of
a body, the laparoscopic instrument having a first tool and a pair
of handles coupled to the first tool; rotating a housing assembly
of the laparoscopic instrument from a locked position to an open
position to expose an end of the first tool; removing the first
tool from a sleeve of the laparoscopic instrument and inserting a
second tool without removing the sleeve from the body; and rotating
the housing assembly from the open position to the locked position
to couple the second tool to the handles of the laparoscopic
instrument.
17. The method of claim 16, further comprising pressing a locking
lever to release the housing assembly from the locked position.
18. The method of claim 16, further comprising pressing the locking
lever to release the housing assembly from the open position.
19. The method of claim 16, further comprising rotating one of the
handles to cause a linear movement of a tool device of the first
tool or the second tool.
20. The method of claim 16, further comprising rotating the housing
assembly about any axis of the laparoscopic instrument lying in the
3-dimensional space occupied by the laparoscopic instrument.
21. A method of exchanging tools in a surgical instrument,
comprising: inserting a first tool through an elongated sleeve of
the surgical instrument; moving part of the surgical instrument to
permit removal of the first tool from the elongated sleeve;
removing the first tool from the elongated sleeve; and inserting a
second tool into the elongated sleeve.
22. The method of claim 21, wherein the surgical instrument is a
laparoscopic instrument or an arthroscopic instrument.
23. The method of claim 21, further comprising inserting the
surgical instrument together with its elongated sleeve through a
cannula into the body.
24. The method of claim 21, wherein the moving includes rotating a
housing assembly of the surgical instrument to expose an end of the
first tool to be removed.
Description
RELATED APPLICATIONS
[0001] This application claims priority to U.S. Provisional Patent
Application Ser. No. 60/690,968 filed Jun. 16, 2005, titled
"Laparoscopic Tool Coupler," and U.S. Provisional Patent
Application Ser. No. 60/711,347 filed Aug. 25, 2005, titled
"Laparoscope's Tool With In Situ Tool Exchange," each of which is
incorporated herein in its entirety.
FIELD OF THE INVENTION
[0002] The present invention relates generally to laparoscopic
instruments and, more particularly, to a laparoscopic instrument
for in situ tool exchange.
BACKGROUND OF THE INVENTION
[0003] Laparoscopic instruments are used during laparoscopy
procedures, which are generally used to examine a patient and/or to
perform minor surgery on the patient. For example, a laparoscopic
instrument can be used to examine the patient's abdominal cavity
for signs of disease or abnormality. In addition, fully invasive
surgery may be avoided by using the laparoscopic instrument to
perform relatively minor surgery. Similarly, in minimally invasive
arthroscopic procedures, such as on a knee joint, an arthroscopic
instrument is used to access joints or bones.
[0004] The laparoscopic (or arthroscopic) instrument generally
includes a grasping end and an operating end that are connected by
a flexible hollow cylindrical shaft. The laparoscopic instrument is
introduced into the patient through a cannula/trocar unit. After
the laparoscopic instrument is inserted into the patient through a
cannula that is anchored to the body via a small incision, the
surgeon may insert one of a plurality of laparoscopic tools into
the laparoscopic instrument to perform a particular surgical
procedure. For example, if a grasping procedure is required the
surgeon will insert a grasping tool in the laparoscopic instrument.
Similarly, if a cutting procedure is required the surgeon will
insert a cutting tool in the laparoscopic instrument.
[0005] One problem associated with current laparoscopic instruments
is that they may cause the surgeon to lose his or her "feel" when
changing laparoscopic tools. During surgery, the surgeon develops a
particular "feel" associated with the location and positioning of
the laparoscopic instrument relative to the patient's internal
cavities. Because the surgeon may be required to perform several
procedures during a single surgery, each procedure requiring a
different laparoscopic tool, the surgeon may lose the "feel" when
changing the laparoscopic tools.
[0006] In one exemplary scenario, the surgeon uses an examination
tool to find the best location for performing a cutting procedure.
After finding the best location, the surgeon retrieves the
laparoscopic instrument from within the patient, replaces the
examination tool with a cutting tool, and reinserts the
laparoscopic instrument inside the patient. It can be time
consuming and frustrating for the surgeon to locate, for a second
time, the best location for performing the cutting procedure.
[0007] Another problem associated with current laparoscopic
instruments is that they have a fixed grasping end and, therefore,
limit the ability and/or comfort of the surgeon in attaining
desired positions within the patient's body. Depending on the
surgical procedure, the surgeon must often change the position of
the laparoscopic instrument or contort his or her body position to
reach various parts of a patient's internal cavity. For example,
the surgeon will often attempt to achieve the best cutting position
before performing a delicate cutting procedure by rotating and/or
moving the grasping end of the laparoscopic tool at various
uncomfortable and awkward positions. Because the grasping end of
the laparoscopic instrument is fixed, the surgeon must perform the
cutting procedure by grasping the laparoscopic tool at an
uncomfortable or awkward position that decreases the likelihood of
a successful surgical procedure, or must contort his or her body to
access a hard-to-reach area of the patient's internal cavity.
[0008] Yet another problem associated with current laparoscopic
instruments is that the surgeon must clasp the operating end
together in order to hold a grasping tool in a closed position.
Prolonged clasping results in hand fatigue and also undesirably
ties up one of the surgeon's hands to perform other tasks. If the
surgeon removes or relaxes his hand from the grasping end, then the
grasping tool may lose its grip on the internal body structure it
was grasping.
[0009] Thus, there is a need to provide a laparoscopic tool that
allows the surgeon to retain the "feel" developed during a surgical
procedure by changing laparoscopic tools without having to remove
the laparoscopic instrument from within the patient's body. There
is also a need for an adjustable grasping end for a laparoscopic or
arthroscopic instrument for attaining desired and/or comfortable
operating positions. There is yet another need for a laparoscopic
or arthroscopic instrument that can lock a grasping tool in a fixed
position without requiring manual clasping by the surgeon. The
present invention fulfills these and other needs.
SUMMARY OF THE INVENTION
[0010] In an aspect of the present invention, a method is presented
for replacing a tool of a laparoscopic instrument without removing
the laparoscopic instrument from a body. The method includes
rotating a housing portion of the laparoscopic instrument to expose
an end of the tool to be removed, removing the tool from the
laparoscopic instrument without removing the laparoscopic
instrument from the body, and inserting a second tool into a sleeve
of the laparoscopic instrument. The method may further include
registering the exposed end of the tool in at least one of a
ball-receiving slot and a ball-receiving hole of the housing
portion when the housing assembly portion is in a locked position
or pressing a locking lever to unlock the housing assembly from a
locked position. The rotating may include rotating the housing
portion about an axis of the laparoscopic instrument selected from
a group consisting of an X-axis, a Y-axis, and a Z-axis. The X-axis
is any axis lying in the 3-dimensional space occupied by the
laparoscopic instrument. Alternately, the rotating may include
rotating the housing assembly about a hinge of the laparoscopic
instrument, the housing assembly being pivotably coupled to the
hinge via a hinge pin. The method may further include grasping a
pair of handles when rotating the housing assembly. The pair of
handles is attached to the housing assembly. The method may still
further include linearly displacing the tool when the housing
assembly is in a locked position to manipulate a tool device
located at an opposing end of the tool.
[0011] In another aspect of the present invention, a laparoscopic
instrument includes a housing assembly that includes a pair of
handles and a hinge portion. The hinge portion is pivotally
connected to the housing portion and includes a tool knob extension
for insertion into an incision of a body. The knob extension
includes an open end and an elongated hollow shaft (sleeve) for
receiving a first tool for insertion into the sleeve through the
open end. The hinge portion is pivotable between a closed position
and an open position and is positioned in the open position with
the knob extension remaining in the body when changing the first
tool with a second tool. The housing assembly may include a drum
assembly having at least two drums connected to respective ones of
the pair of handles. The drums rotate independently of one another
to permit movement of the handles relative to one another. The
drums also rotate together in a fixed relationship about an axis
passing through the center of the drums to permit rotation of the
handles in a fixed relationship about the axis. The hinge in the
closed position may rotate around an axis perpendicular to an axis
of the knob extension to achieve the open position. Alternately,
the hinge portion in the closed position may rotate around an axis
parallel to an axis of the knob extension to achieve the open
position. The hinge portion may further include a locking lever for
locking the hinge portion in at least the locked position and the
open position. The housing assembly may include a ball-receiving
slot for receiving a ball end of any of the first tool and the
second tool when the hinge portion is in the closed position.
[0012] In yet another aspect of the present invention, a method of
replacing a tool of a laparoscopic instrument includes inserting a
laparoscopic instrument into an incision of a body having a first
tool and a pair of handles coupled to the first tool. A housing
assembly of the laparoscopic instrument is rotated from a locked
position to an open position to expose an end of the first tool.
The first tool is removed and a second tool is inserted without
removing the laparoscopic instrument from the body. The housing
assembly is rotated from the open position to the locked position
to couple the second tool to the handles of the laparoscopic
instrument. The method may further pressing a locking lever to
release the housing assembly from the locked position or pressing
the locking lever to release the housing assembly from the open
position. The method may further rotating one of the handles to
cause a linear movement of a tool device of the first tool or the
second tool. The method may still further include rotating the
housing assembly about any axis of the laparoscopic instrument
lying in the 3-dimensional space occupied by the laparoscopic
instrument.
[0013] In still another aspect of the present invention, a method
of exchanging tools in a surgical instrument includes inserting a
first tool through an elongated sleeve of the surgical instrument,
moving part of the surgical instrument to permit removal of the
first tool from the elongated sleeve, removing the first tool from
the elongated sleeve, and inserting a second tool into the
elongated sleeve. The surgical instrument can be a laparoscopic
instrument or an arthroscopic instrument. The method may further
include inserting the surgical instrument together with its
elongated sleeve through a cannula into the body. The moving may
include rotating a housing assembly of the surgical instrument to
expose an end of the first tool to be removed.
[0014] The above summary of the present invention is not intended
to represent each embodiment, or every aspect, of the present
invention. Additional features and benefits of the present
invention are apparent from the detailed description, figures, and
claims set forth below.
BRIEF DESCRIPTION OF THE FIGURES
[0015] FIG. 1A is an exploded perspective view showing a first
portion of a laparoscopic instrument according to one embodiment of
the present invention.
[0016] FIG. 1AI is a perspective bottom view of the tool drum shown
in FIG. 1A according to an embodiment of the present invention.
[0017] FIG. 1B is an exploded perspective view showing a second
portion to the laparoscopic instrument shown in FIG. 1A.
[0018] FIG. 2 is an assembly perspective view of the laparoscopic
instrument of FIGS. 1A and 1B.
[0019] FIG. 3 is a front view of the laparoscopic instrument of
FIGS. 1A and 1B.
[0020] FIG. 4 is a top view of the laparoscopic instrument of FIGS.
1A and 1B.
[0021] FIG. 5 is a back view of the laparoscopic instrument of
FIGS. 1A and 1B.
[0022] FIG. 6 is a bottom view of the laparoscopic instrument of
FIGS. 1A and 1B.
[0023] FIG. 7 is a left-side view of the laparoscopic instrument of
FIGS. 1A and 1B, showing a tool end of the laparoscopic
instrument.
[0024] FIG. 8 is a right-side view of the laparoscopic instrument
of FIGS. 1A and 1B, showing a handle-end of the laparoscopic
instrument.
[0025] FIG. 9 is an exploded perspective view showing a drum
subassembly of the laparoscopic instrument of FIGS. 1A and 1B.
[0026] FIG. 10 is an assembly perspective view showing interior
details of the drum subassembly of FIG. 9.
[0027] FIG. 11 is a planar cross-sectional view of the drum
subassembly of FIG. 9.
[0028] FIGS. 12A-12C are perspective views of an assembly
comprising a winged shaft and a handle drum according to three
alternative embodiments of the present invention, respectively.
[0029] FIG. 13 is a cross-sectional view representing the
interaction between a winged shaft and a drum subassembly according
to an embodiment of the present invention.
[0030] FIG. 14 is a perspective cross-sectional view of the drum
subassembly of FIG. 9 showing a push-button in a fully depressed
position and a pair of handles in a first position.
[0031] FIG. 15 is a perspective cross-sectional view showing the
push-button of FIG. 14 in the fully depressed position and the pair
of handles in a second position.
[0032] FIG. 16 is a perspective cross-sectional view showing the
push-button of FIG. 14 in an un-depressed position and the pair of
handles in the second position.
[0033] FIG. 17 is a partial exploded perspective view showing a
shotgun subassembly of the laparoscopic instrument of FIGS. 1A and
1B in an open breech position.
[0034] FIG. 18 is a perspective view of the shotgun subassembly of
FIG. 17 in an open breech position exposing an insertion end of a
laparoscopic tool.
[0035] FIG. 19 is a perspective view of the shotgun subassembly of
FIG. 17 showing an assembled shotgun subassembly in an open breech
position.
[0036] FIG. 20A is a representative diagrammatic front view showing
an alternative embodiment of a shotgun subassembly rotating about
an X-axis of a laparoscopic instrument.
[0037] FIG. 20B is a representative side view of FIG. 20A.
[0038] FIG. 21A is a representative top view showing another
alternative embodiment of a shotgun subassembly rotating about a
Y-axis of a laparoscopic instrument.
[0039] FIG. 21B is a representative front view of FIG. 22A.
[0040] FIG. 22A is a perspective view of a pair of handles of the
laparoscopic instrument of FIGS. 1A and 1B in an open aligned
position.
[0041] FIG. 22B is a perspective view of the pair of handles of
FIG. 22A in a locked position.
[0042] FIG. 23A is a perspective view of the pair of handles of
FIG. 22A in a closed offset position.
[0043] FIG. 23B is a perspective view of the pair of handles of
FIG. 22A in an open offset position.
[0044] While the invention is susceptible to various modifications
and alternative forms, specific embodiments are shown by way of
example in the drawings and are described in detail herein. It
should be understood, however, that the invention is not intended
to be limited to the particular forms disclosed. Rather, the
invention is to cover all modifications, equivalents, and
alternatives falling within the spirit and scope of the invention
as defined by the appended claims.
DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS
[0045] Referring to FIGS. 1A and 1B, a general description of the
parts associated with a laparoscopic instrument 100 is provided
according to an embodiment of the present invention. A more
detailed description of the parts and their associated movements is
provided in subsequent drawings. The laparoscopic instrument 100
includes a push button 102 that has a generally cylindrical disk
shape. The push button 102 is connected to a winged shaft 104 via a
push-button screw 106, which is inserted through a central hole of
the push button 102. The push button 102 is adjacent to a spring
108, which includes one end that is in contact with the push button
102 and another end that is in contact with a tool cover 110.
[0046] The tool cover 110 is a generally cylindrical plate that
includes a central hole and a plurality of tapped periphery holes.
The winged shaft 104 protrudes through the central hole of the tool
cover 110 toward the push button 102. Two connecting screws 112
connect the tool cover 110 to a housing 114.
[0047] The housing 114 includes a drum receiving portion 116 for
accommodating at least in part a tool drum 118, a trigger drum 120,
and a fixing drum 122, each of which is located adjacent to one
another as shown. The housing 114 further includes a ball-receiving
slot 115 for allowing pivoting movement of the housing 114, as
described in more detail below in reference to FIGS. 17-19.
[0048] Referring to FIG. 1AI, the tool drum 118 is illustrated as
being generally cylindrical, having a central through-hole, which
is cylindrically shaped, and including a plurality of slots through
which the winged shaft 104 protrudes. Although the plurality of
slots is shown having three slots, alternatively, any number of
slots may be used. The slot height extends only through part of the
tool drum 118 (i.e., the slots are not through-slots). For example,
the slot height is half the height of the tool drum 118. In
alternative embodiments, the slot height extends through the entire
tool drum 118. In yet other alternative embodiments, the central
hole can have any other three-dimensional shape, e.g., a partial
toroid, for receiving the winged shaft 104 therethrough. As
explained in more detail below, the slots of the tool drum 118
engage the winged shaft 104 for securing the tool drum 118 to the
fixing drum 122 in any one of a plurality of positions.
[0049] A drum washer 124 and a plug 126 is located between the tool
drum 118 and the housing 114. The tool drum 118 includes a
ball-receiving hole 127 along its periphery as shown.
[0050] The trigger drum 120 is generally cylindrical and is
attached to a trigger handle 128 that includes a latching mechanism
130. The trigger drum 120 is attached to the trigger handle 128
directly or through a mechanical linkage. The trigger drum 120
includes a central slotted hole having substantially the same shape
and dimensions as the slotted hole of the tool drum 118 through
which the winged shaft 104 protrudes. The fixing drum 122 is
generally cylindrical and is attached to a fixing handle 132 that
includes a locking part 134 for the latching mechanism 130. The
fixing drum 122 is attached to the fixing handle 132 directly or
through a mechanical linkage. The fixing drum 122 includes a
central slotted hole having substantially the same shape and
dimensions as the slotted holes of the tool drum 118 and the
trigger drum 120 through which the winged shaft 104 protrudes. The
fixing drum 122 further includes a plurality of fixing holes 135
for securing the fixing drum 122 as described in more detail
below.
[0051] The winged shaft 104 includes a generally cylindrical shaft
136 and a plurality of winglets 138, which are arranged in two
symmetrical pairs along the shaft 136. The winglet end of the
winged shaft 104 is attached to a locking plate 140 via a locking
screw 142. In alternate embodiments, the winglets 138 can be
splines or parts thereof, keys, or pins.
[0052] A fixing cover 144 is located along the winged shaft 104,
between the locking plate 140 and the fixing drum 122. The fixing
cover 144 includes a central slotted hole having substantially the
same shape and dimensions as the slotted holes of the tool drum
118, the trigger drum 120, and the fixing drum 122 through which
the winged shaft 104 protrudes. In addition, the fixing cover 144
includes a plurality of push-pin receiving holes through which
corresponding push pins 146 are inserted. The push pins 146
protrude through the locking plate 140, the fixing cover 144, and
the fixing holes 135 to secure the fixing drum 122 to the locking
plate 140.
[0053] The locking plate 140 includes a recessed groove 148 for
receiving the winged shaft 104 and a plurality of push-pin
receiving holes through which corresponding push pins 146 are
inserted. A locking washer 150 is inserted between the head of the
locking screw 142 and the locking plate 140.
[0054] Turning now to FIG. 1B, the housing 114 is pivotably
connected to a hinge 152 via a hinge pin 154, which is inserted
through a plurality of hinge pivot holes 156. The housing 114 is
attached to the hinge 152 at a housing pivoting portion 157, which
is inserted in a hinge slotted area of the hinge 152.
[0055] The hinge 152 includes a locking lever 158, which is
attached to the hinge 152 via a lever screw 160. The locking lever
158 is inserted in a lever slot 159, which is located at a bottom
end of the hinge 152. A lever spring 162 is positioned within the
lever slot 159 for maintaining the locking lever 158 in a closed
position. The locking lever 158 includes an actuating end 163 and a
locking end 165. The actuating end 163 is actuated by urging the
locking lever 158 toward the lever spring 162 to unlock the hinge
152 from a closed position to an open position, as described in
more detail below in reference to FIGS. 17-19. When the locking
lever 158 is pressed, it rotates around the axis of the lever screw
160 such that the locking end 165 causes the hinge 152 to pivot
about the axis of the hinge pin 154 (the Z-axis).
[0056] A long bearing 164 and a short bearing 166 are used to
rotatably attach a knob 168 to the hinge 152. A plurality of
set-screws 170 are screwed into the knob 168 for retaining the long
bearing 165 and the short bearing 166 relative to the knob 168.
[0057] A knob extension or sleeve 172 is attached to the knob 168
using a threaded end of the knob extension 172. The knob extension
172 is a hollow shaft (or sleeve) that is used for accommodating a
tool holder 174, which is inserted into the hollow of the knob
extension 172. The tool holder 174 is a hollow shaft that
accommodates a tool 176, which includes a ball 178 at an insertion
end and a scissors device 180 at an operating end. The tool 176 is
inserted into the tool holder 174, as shown. According to the shown
embodiment, the scissors device 180 is a three-member claw device.
The outer surface of the sleeve 172 may be composed of or coated
with an insulating material, such as Teflon, to electrically
insulate the operator of the instrument 100 from the sleeve 172
when using an electric tool such as a cauterizing tool. For
example, the sleeve 172 is wrapped with a Teflon shrink tube.
[0058] FIGS. 2-8 show various views of the laparoscopic instrument
100 in an assembled form and depict representative movements of the
trigger handle 128. The tool drum 118, the trigger drum 120, and
the fixing drum 122 are assembled together with the housing 114.
The trigger handle 128 and the fixing handle 132 are shown in a
locked position, which is described in more detail below. The
housing 114 and the hinge 152 are shown in a closed position, and
the ball 178 is received by the ball-receiving hole 127 of the tool
drum 118.
[0059] As represented by the phantom lines, the trigger handle 128
is rotated relative to the fixing handle 132 in a counter
clock-wise direction (from the locked position) to open the
scissors device 180 at the operating end of the tool 176. In
general, the rotation of the trigger handle 128 causes the rotation
of the tool drum 118, which in turn causes the linear movement of
the tool 176. The linear movement of the tool 176 causes an
opening/closing movement for the scissors device 180. The
relationship between the three drums 118, 120, 122 (also referred
to as the drum sandwich assembly) is described in more detail
below.
[0060] In addition, as best seen in FIG. 3, the position of the
shaft 136 (represented by the push-button screw 106) can be aligned
with the hinge pivot hole 156 or can be different than the position
of the hinge pivot hole 156. For example, the center of the shaft
136 can be at the same distance in the Y-axis direction from the
X-axis of the tool 176 as the hinge pivot hole 156. Alternatively,
the distance between the center of the shaft 136 and the X-axis of
the tool 176 can be smaller or greater than the distance between
the hinge pivot hole 156 and the X-axis of the tool 176.
[0061] An electrical probe 182 is protruding from and is attached
to the housing 114. The electrical probe 182 is electrically
coupled to the tool 176 (such as a cauterizing tool) to supply
electrical current from an external power supply. For example,
electrical current is supplied via the electrical probe 182 to an
electrocautery tool 176 for cauterizing organ tissue during a
surgical procedure. Alternatively, a hole or plug is formed in the
housing 114 for receiving an electrode therein.
[0062] Referring to FIGS. 9-11, the tool drum 118, the trigger drum
120, and the fixing drum 122 are sandwiched between the tool cover
110 (located at the top, adjacent to the tool drum 118) and the
fixing cover 144 (located at the bottom, adjacent to the fixing
drum 122). The push button 102 is located at the top of the drum
sandwich assembly--near the tool cover 110--and the locking plate
140 is located at the bottom of the drum sandwich assembly--near
the fixing cover 144. The shaft 136 protrudes through each of the
fixing cover 144, the fixing drum 122, the trigger drum 120, the
tool drum 118, and the tool cover 110. The shaft 136 is attached
via the locking screw 142 to the locking plate 140 and via the
push-button screw 106 to the push button 102. The shaft 136 also
protrudes through the spring 108.
[0063] The winglets 138 attached to the shaft 136 are adapted to
protrude only through corresponding slots of the tool drum 118, the
trigger drum 120, the fixing drum 122, and the fixing cover 144.
Depending on whether the push button 102 is in a depressed or
un-depressed position, the winglets 138 protrude through only some
of the tool drum 118, the trigger drum 120, the fixing drum 122,
and the fixing cover 144. Depending on the position of the winglets
138, the rotatable movement of the trigger drum 120 is locked with
respect to either the tool drum 118 or the fixing drum 122.
[0064] The winglets 138 include a pair of top winglets 138a and a
pair of bottom winglets 138b. As shown in FIGS. 10-11, the push
button 102 is in an un-depressed position in which the top winglets
138a protrude through the tool drum 118 and the trigger drum 120.
In the un-depressed position, the rotatable movement of the trigger
drum 120 is fixed with respect to the tool drum 118. If the push
button 102 is in a depressed position, the top winglets 138a rotate
within the trigger drum 120 (where the bottom winglets 138b are
located in the un-depressed position), and the bottom winglets 138b
rotate within the fixing drum 122. In the depressed position, the
rotatable movement of the trigger drum 120 is fixed with respect to
the fixing drum 122. The novel arrangement according to the present
invention allows the handles 128, 132 to be rotated regardless of
the position of the trigger drum 120 relative to the tool drum 118.
This aspect advantageously allows the surgeon to manipulate the
handles 128, 132 in any drum position. According to the present
invention, instead of having to twist or contort the surgeon's body
in order to access a hard-to-reach area of a patient's inner
cavity, the surgeon simply rotates the drum to achieve a new
position and can continue to manipulate the handles 128, 132, which
control the tool 176 inside the patient's body. It is advantageous
for the handles 128, 132 to be manipulatable even as they are
rotated together around the shaft 136.
[0065] Referring to FIGS. 12A-12C, alternative embodiments of the
winged shaft 136 of FIGS. 1-11 are shown depicting three different
winglet combinations. For ease of understanding, FIG. 12B shows the
winged shaft 104 of FIGS. 1-11, including the shaft 136 and the two
sets of winglets 138. In an alternative embodiment, shown in FIG.
12A, a winged shaft 1204a includes a shaft 1236a and a single set
of winglets 1238a. To accommodate the single set of winglets 1238a,
the holes through which the winged shaft 1204a protrudes (e.g.,
slotted hole of a trigger drum 1220a) are modified to include a
single slot 1239a. Each winglet in the set of winglets 1238a is
spaced to lock at most any two drums together when rotated.
[0066] In another alternative embodiment, shown in FIG. 12C, a
winged shaft 1204c includes a shaft 1236c and three sets of
winglets 1238c approximately 120 degrees apart. To accommodate the
three sets of winglets 1238c, the holes through which the winged
shaft 1204c protrudes (e.g., slotted hole of a trigger drum 1220c)
are modified to include three slots 1239c.
[0067] Referring to FIG. 13, a schematic cross-sectional
representation illustrates the relationship between a winged shaft
1304 and a plurality of drums, a tool drum 1318, a trigger drum
1320, and a fixing drum 1322, and various positions of the winged
shaft 1304 relative to the drums 1318, 1320, 1322. The winged shaft
1304 includes a shaft 1336 and a set of two winglets 1338. From
left to right, the drums include the tool drum 1318, the trigger
drum 1320, and the fixing drum 1322. The drums 1318, 1320, 1322 are
housed within a housing 1314 such that each drum can rotate freely
unless fixed in place by the winglets 1338. The drums 1318, 1320,
1322 are fixed from rotational movement when the winglets 1338
protrude through corresponding drum slots. Movement of the winged
shaft 1304 interlocks one or more of the drums 1318, 1320, 1322
with respect to each other to achieve a desired rotational
combination. For example, as described below, movement of the
winged shaft 1304 in any of a plurality of positions A-F achieves
any desired rotational combination for the drums 1318, 1320, 1322.
As shown in FIG. 13, the winglet and drum combinations can be used
to provide a sort of "binary logic" for mechanical devices, such as
gears and clutches. The versatility of using the winglets and the
drums in accordance with the present invention allows any
combination of drum movements to be realized. The concepts of FIG.
13 and related embodiments can be implemented in any mechanical
system, including laparoscopic instruments. The present invention
expressly contemplates that the lock-and-release embodiments shown
and described herein is not limited to laparoscopic
instruments.
[0068] At position A, the winglets 1338 are positioned to the right
of the fixing drum 1322. In this position, each of the drums 1318,
1320, 1322 is free to rotate with respect to each other.
[0069] At position B, the winged shaft 1304 is moved toward the
drums 1318, 1320, 1322 such that the winglets 1338 are positioned
within the fixing drum 1322 only. Accordingly, in this position the
fixing drum 1322 is fixed from rotational movement, while the tool
drum 1318 and the trigger drum 1320 are free to rotate.
[0070] At position C, the winged shaft 1304 is moved further toward
the drums 1318, 1320, 1322 such that the winglets 1338 are
positioned within both the trigger drum 1320 and the fixing drum
1322. Accordingly, in this position the trigger drum 1320 and the
fixing drum 1322 are fixed from rotational movement, while the tool
drum 1318 is free to rotate.
[0071] At position D, the winged shaft 1304 is moved further toward
the drums 1318, 1320, 1322 such that the winglets 1338 are
positioned within all three drums. Accordingly, in this position
each of the drums 1318, 1320, 1322 is fixed from rotational
movement.
[0072] At position E, the winged shaft 1304 is moved further toward
the drums 1318, 1320, 1322 such that the winglets 1338 are
positioned within the tool drum 1318 and the trigger drum 1320.
Accordingly, in this position the tool drum 1318 and the trigger
drum 1320 are fixed from rotational movement, while the fixing drum
1322 is free to rotate.
[0073] At position F, the winged shaft 1304 is moved further toward
the drums 1318, 1320, 1322 such that the winglets 1338 are
positioned within the tool drum 1318 only. Accordingly, in this
position the tool drum 1318 is fixed from rotational movement,
while the trigger drum 1320 and the fixing drum 1322 are free to
rotate.
[0074] Referring to FIGS. 14-16, a cut-away perspective view of the
drums 118, 120, 122 is shown revealing the winged shaft 104 in
various positions together with the winglets 138. With reference to
these figures, the movement of the winged shaft 104 and of the
handles 128, 132 will now be described in more detail. In FIG. 14,
the push button 102 is shown in a depressed position, and the
handles 128, 132 are shown in a first position. Depressing the push
button 102 causes the winged shaft 104 to slide in a direction away
from the movement of the push button 102 until the top winglets
138a are located within the trigger drum 120 and the bottom
winglets 138b are located within the fixing drum 122. In this
configuration, the trigger drum 120 and the fixing drum 122 are
fixed or locked together, which in turn locks the handles 128, 132
together. In addition, the locking plate 140 and the push pins 146
are correspondingly urged away from the fixing drum 122, which is
now disengaged from the locking plate 140 and the push pins
146.
[0075] Accordingly, in the depressed position the trigger drum 120
and the fixing drum 122 are locked with respect to each other.
Further, because the fixing drum 122 is now disengaged from the
locking plate 140 and the push pins 146, the combination of the
trigger drum 120 and the fixing drum 122 is free to rotate around
the Z-axis (the axis of the winged shaft 104).
[0076] In FIG. 15, the push button 102 remains in the depressed
position. However, the handles 128, 132 have been rotated counter
clock-wise from the first position to a second position. Thus, the
only two components that change their position from the first
position to the second position are the trigger handle 128 and the
fixing handle 132. For example, the position of the tool drum 118
remains unchanged. By rotating the handles 128, 132 to a new
position, while maintaining the position of the tool drum 118, a
surgeon using the laparoscopic instrument 100 may be able to
achieve a better grasping position for the handles 128, 132 without
changing the position of the tool 176 inside a patient and without
contorting or twisting the surgeon's body to maintain a comfortable
and firm grasp.
[0077] As can be seen in FIGS. 1A and 9, the fixing handle 132 is
secured to the locking plate 140 by inserting the push pins 146
through the fixing holes 135. Three pairs of fixing holes 135 are
shown, and each fixing hole pair represents a different handle
position (up to three different positions in the embodiment shown
in FIG. 1A). When the push button 102 is depressed, the push pins
146 disengage the fixing holes 135, allowing the fixing drum 122 to
freely rotate. The force exerted by the spring 108 allows the
surgeon to rotate the fixing drum 122 (and thereby the fixing
handle 132) until the push pins 146 "click" into alignment with a
different set of fixing holes 135. Although three pairs of fixing
holes 135 are shown allowing the fixing handle 132 to be rotated
among one of three different positions, fewer or additional fixing
holes are contemplated in other embodiments to allow the fixing
handle 132 to be rotated among a corresponding number of positions.
For example, if four positions are desired, four pairs of fixing
holes 135 are formed in the fixing drum 122 and spaced according to
each desired position. Although two push pins 146 are shown in FIG.
1A, in other embodiments, a different number of push pins is used
instead.
[0078] In FIG. 16, the push button 102 is shown in the un-depressed
position to engage the fixing drum 122 to the locking plate 140 and
the trigger drum 120 to the tool drum 118. The winglets 138 are now
located within the tool drum 118 and the trigger drum 120 to secure
the tool drum 118 and the trigger drum 120 to each other. The push
pins 146 engage the fixing drum 122, fixing the handles 128, 132 in
a second position. When the tool drum 118 and the trigger drum 120
are fixed relative to each other, i.e., in the un-depressed
position, the trigger handle 128 may be partially rotated. The
rotation of the trigger handle 128 causes the rotation of the tool
drum 118, which in turn causes the linear movement of the tool 176.
The linear movement of the tool 176 allows the surgeon to use the
operating end of the tool 176. For example, a counter clock-wise
movement of the trigger handle 128 causes the opening of the
scissors device 180, while a clock-wise movement of the trigger
handle 128 causes the closing of the scissors device 180.
[0079] Referring to FIGS. 17-19, there is shown a shotgun
subassembly of the laparoscopic instrument 100 in an open "breech"
position. The term "shotgun" subassembly refers to the resemblance
of the laparoscopic instrument 100 to the breech of a shotgun,
which allows the surgeon to replace the laparoscopic tool without
removing the instrument 100 from the patient's body. While the
instrument 100 is inserted into the patient's body, the shotgun
subassembly can be opened and closed like a shotgun to expose one
end of the tool for removal and reinsertion. The laparoscopic
instrument 100 includes a hinge portion 1700 and a housing portion
1702, which together form the shotgun subassembly having a "breech"
that is pivotable about a hinge 152. The hinge portion 1700
generally includes the hinge 152, the tool 176, and the scissors
device 180. The housing portion 1702 generally includes the housing
114, the handles 128, 132, and the drums 118, 120, 122. The
pivoting of the hinge 152 with respect to the housing 114 of the
laparoscopic instrument 100 is described in more detail in
connection with FIGS. 18 and 19. In FIG. 17, the hinge 152 is
assembled to the housing pivoting portion 157 using the hinge pin
154. The housing 114 pivots about the hinge pin 154 in the Z-axis
to provide the opening and/or closing movement of the housing
portion 1702 with respect to the hinge portion 1700.
[0080] In FIGS. 18 and 19, the hinge portion 1700 is shown in an
open position, having been pivoted in a counter clock-wise
direction about the Z-axis from the closed position. As the hinge
portion 1700 is urged toward the open position, the ball 178--along
with the tool 176--is retracted from the ball-receiving hole 127 of
the tool drum 118. To open the hinge portion 1700, the locking
lever 158 is pressed in a direction toward the tool 176 (as
described earlier in reference to FIG. 1B) such that the locking
end 165 (shown in FIG. 1B) releases the housing pivoting portion
157. As the hinge portion 1700 is urged toward the open position,
the ball 178 passes through the ball-receiving slot 115 formed in
the housing 114 until the ball 178 exits the ball-receiving slot
115. After moving the hinge portion 1700 into the open position,
the surgeon can remove the tool 176 from within the hinge portion
1700 and replace it with another laparoscopic tool without removing
any other part of the instrument 100 from the patient's body. Thus,
during the tool replacement, the knob extension or sleeve 172
remains inside the patient in a fixed position. In other words, in
contrast to prior art laparoscopic instruments, the surgeon is not
required to remove the instrument 100 from within the patient in
order to replace the tool 176 with another tool. Maintaining the
instrument 100 inside the patient while exchanging tools
advantageously eliminates the need for the surgeon to search for
and find a previously located body part or position.
[0081] The location of the ball-receiving hole 127 is found by
drawing a circle about the hinge pin 154, whose radius extends to
the end of the ball 178 (when the tool 176 is fully inserted into
the knob extension 172). Where the circle intersects the tool drum
118 is where the manufacturer should form the ball-receiving hole
127.
[0082] In an alternate embodiment, instead of adapting the hinge
portion 1700 to swing open, the hinge portion 1700 is adapted to
slide open. For example, instead of having the housing 114
rotatable with respect to the hinge 152, the housing 114 slides
open with respect to the hinge 152 in, for example, a direction of
the Z-axis, to allow the removal and/or insertion of the tool
176.
[0083] Referring to FIGS. 20A and 20B, an alternative embodiment of
the present invention shows a laparoscopic instrument 2000 that
includes a housing 2014 and a hinge 2052. The hinge 2052 pivots
around an X-axis of the laparoscopic instrument 2000. Specifically,
the hinge 2052 pivots around a hinge pin 2052, which is inserted
through a hinge pivot hole 2056, with respect to the housing
2014.
[0084] Referring to FIGS. 21A and 21B, an alternative embodiment of
the present invention shows a laparoscopic instrument 2100 that
includes a housing 2114 and a hinge 2152. The hinge 2152 pivots
around a Y-axis of the laparoscopic instrument 2100. Specifically,
the hinge 2152 pivots around a hinge pin 2152 with respect to the
housing 2114. Slots in the housing 2014 and 2114, respectively, and
respective drums will enable the exposed part of each respective
shaft and ball to travel into each respective drum.
[0085] Referring to FIGS. 22A-23B, the locking of the trigger
handle 128 with respect to the fixing handle 132 will be described
in more detail. In FIG. 22A, the handles 128, 132 are in an open
and aligned position relative to one another. In the open position
there is no contact between the latching mechanism 130 of the
trigger handle 128 and the locking part 134 of the fixing handle
132. The latching mechanism 130 and the locking part 134 include a
plurality of corresponding teeth 2282 that are biased so as to lock
the handles 128, 132 to each other, as described in more detail
below in reference to FIG. 22B.
[0086] The trigger handle 128 further includes a latching lever
2284, which is pivotally connected to the trigger handle 128 at a
pivoting point 2286, and a lever limiter 2288. The lever limiter
2288 limits the rotational movement of the latching lever 2284 to a
distance that is sufficient for disengaging engaged ones of the
teeth 2282. A reason for limiting the rotational movement of the
latching lever 2284 is to prevent the latching lever 2284 from
interfering with the operation of the laparoscopic instrument 100.
The latching mechanism 130 is mounted on the latching lever 2284
such that the latching mechanism 130 moves whenever the latching
lever 2284 is moved. The aligned position shows the latching lever
2284 parallel to the fixing handle 132 in the X-Y plane.
[0087] In FIG. 22B, the handles 128, 132 are shown in a locked
position, and the handles 128, 132 are correspondingly in a closed
and aligned position. The latching mechanism 130 and the locking
part 134 are interlocked via the plurality of corresponding teeth
2282, which are included in each of the latching mechanism 130 and
the locking part 134. To lock the handles 128, 132, at least one of
the handles 128, 132 is rotated around the Z-axis toward the other
one of the handles 128, 132. For example, the trigger handle 128 is
rotated in a clockwise direction toward the fixing handle 132.
Corresponding ones of the teeth 2282 are engaged via frictional
forces to prevent movement of the handles 128, 132 toward an open
position. The teeth 2282 are biased to encourage movement of the
handles 128, 132 toward one another but to resist movement of the
handles 128, 132 away from one another. The ability to lock the
handles 128, 132 during surgery advantageously frees the surgeon's
hand to carry out other tasks, while leaving the instrument 100
inside the patient's body. It further permits the surgeon to relax
the hand gripping the instrument 100 to minimize hand fatigue that
can be caused by prolonged grasping and manipulation of the handles
128, 132. Still further, without locking handles, if the surgeon's
hand that is grasping the handles 128, 132 were to momentarily
relax or lose its grip, the tool 176 may slip or dislodge from a
desired position inside the patient's body cavity. When the handles
128, 132 are in the locked position, the tool 176 can be reliably
maintained inside the patient. With the handles locked, the surgeon
may also rotate them together in accordance with the present
invention to a better position without disturbing the position of
the tool 176 inside the body cavity.
[0088] In FIG. 23A, the handles 128, 132 are shown in a closed and
offset position. The handles 128, 132 are fixed with respect to the
Z-axis as the latching lever 2284 is urged in the Z-axis direction
to unlock the latching mechanism 130 from the locking part 134.
When the latching mechanism 130 is moved in the Z-axis direction
away from the locking part 134, via movement of the latching lever
2284, engaged ones of the teeth 2282 disengage, causing the trigger
handle 128 to unlock from the fixing handle 132.
[0089] In FIG. 23B, the handles 128, 132 are shown in an open and
offset position. After the trigger handle 128 is moved in the
Z-axis direction (as shown in FIG. 23A) away from the fixing handle
132, the trigger handle 128 is rotated in a counter-clockwise
direction around the Z-axis. To position the latching lever 2284 in
the initial open and aligned position of FIG. 22A, the latching
lever 2284 must be urged in the Z-axis direction toward the trigger
handle 128 in order to position the latching lever 2284 in the same
X-Y plane as the fixing handle 132. Now, the trigger handle 128 is
ready to be locked relative to the fixing handle 132.
[0090] Preferably, the latching lever 2284 is positioned to be
manipulatable by the surgeon with a single finger, such as with the
pinky finger of the hand grasping the handles 128, 132. In this
respect, the surgeon is not required to remove the hand from the
handles 128, 132 in order to lock or unlock them. In operation, the
surgeon simply moves the latching lever 2284 with the pinky finger,
which is typically not positioned within the handle 128 as are the
ring and middle fingers.
[0091] At least some of the parts described above in reference to
FIGS. 1A-23B are injection-molded parts, which are precision molded
with hot-oil or water molds using high-strength, graphite-, glass-,
or carbon-filled plastics such as PEEK.TM. (polyetheretherketone),
Ultem.RTM. (polyetherimide), Grivory.RTM., or RADEL.RTM. R
(polyphenylsulfone). The injection-molded parts include single
cavity molds and family molds. For example, some of the molded
parts can be cold runner molds.
[0092] Although the foregoing embodiments have been described in
connection with a laparoscopic instrument 100, the present
invention is equally applicable to an arthroscopic instrument.
[0093] While the invention is susceptible to various modifications
and alternative forms, specific embodiments thereof have been shown
by way of example in the drawings and herein described in detail.
It should be understood, however, that it is not intended to limit
the invention to the particular forms disclosed, but on the
contrary, the intention is to cover all modifications, equivalents,
and alternatives falling within the spirit and scope of the
invention as defined by the appended claims.
* * * * *