U.S. patent application number 13/241629 was filed with the patent office on 2012-03-29 for surgical instrument with selectively articulatable end effector.
This patent application is currently assigned to Ethicon Endo-Surgery, Inc.. Invention is credited to Taylor W. Aronhalt, Chester O. Baxter, III, Matthew C. Miller, Katherine J. Schmid, Frederick E. Shelton, IV, Barry C. Worrell, Joseph E. Young.
Application Number | 20120074200 13/241629 |
Document ID | / |
Family ID | 44736089 |
Filed Date | 2012-03-29 |
United States Patent
Application |
20120074200 |
Kind Code |
A1 |
Schmid; Katherine J. ; et
al. |
March 29, 2012 |
SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR
Abstract
A surgical instrument that has an articulatable end effector.
The instrument includes an articulation system that has a rotatable
actuator member that interfaces with an articulation transmission.
Rotation of the actuator member in a first rotary direction about
an actuation axis causes at least one articulation member to
articulate the surgical end effector in a first articulation
direction and rotation of the actuator member in a second rotary
direction causes at least one articulation member to articulate the
surgical end effector in a second articulation direction.
Inventors: |
Schmid; Katherine J.;
(Cincinnati, OH) ; Baxter, III; Chester O.;
(Loveland, OH) ; Aronhalt; Taylor W.; (Loveland,
OH) ; Young; Joseph E.; (Loveland, OH) ;
Shelton, IV; Frederick E.; (Hillsboro, OH) ; Worrell;
Barry C.; (Centerville, OH) ; Miller; Matthew C.;
(Cincinnati, OH) |
Assignee: |
Ethicon Endo-Surgery, Inc.
Cincinnati
OH
|
Family ID: |
44736089 |
Appl. No.: |
13/241629 |
Filed: |
September 23, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61386094 |
Sep 24, 2010 |
|
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|
Current U.S.
Class: |
227/180.1 ;
227/175.1 |
Current CPC
Class: |
A61B 2017/2946 20130101;
A61B 2017/0038 20130101; A61B 2017/2927 20130101; A61B 2017/2908
20130101; A61B 17/07207 20130101 |
Class at
Publication: |
227/180.1 ;
227/175.1 |
International
Class: |
A61B 17/068 20060101
A61B017/068 |
Claims
1. A surgical instrument comprising: a handle assembly; an
elongated shaft assembly operably interfacing with said handle
assembly and defining a longitudinal axis; a surgical end effector
operably coupled to the elongated shaft assembly and configured to
cut and staple tissue upon application of actuation motions
thereto; at least one articulation member operably supported by
said elongated shaft assembly; and an articulation system
comprising: an articulation transmission operably supported by said
handle assembly and operably interfacing with said at least one
articulation member; and an actuator member rotatably supported on
said handle member for selective rotation about an actuation axis
that does not transversely intersect said longitudinal axis, said
actuator member interfacing with said articulation transmission
such that rotation of said actuator member in a first rotary
direction about said actuation axis causes said at least one
articulation member to articulate said surgical end effector
relative to said longitudinal axis in a first articulation
direction and rotation of said actuator member in a second rotary
direction about said actuation axis causes said at least one
articulation member to articulate said surgical end effector
relative to said longitudinal axis in a second articulation
direction relative to said longitudinal axis.
2. The surgical instrument of claim 1 wherein said elongated shaft
assembly has a substantially flexible articulation joint segment
therein that is coupled to said surgical end effector.
3. The surgical instrument of claim 2 wherein said at least one
articulation member comprises: a first articulation band assembly
operably supported by said elongated shaft assembly and coupled to
a portion of said substantially flexible articulation joint segment
on a first side of said longitudinal axis, said first articulation
band assembly operably interfacing with said articulation
transmission; and a second articulation band assembly operably
supported by said elongated shaft assembly and coupled to said
portion of said substantially flexible articulation joint segment
on a second said of said longitudinal axis, said second
articulation band assembly operably interfacing with said
articulation transmission.
4. The surgical instrument of claim 1 wherein said actuation axis
is substantially coaxial with said longitudinal axis.
5. The surgical instrument of claim 4 wherein said articulation
transmission comprises: a first articulation disc movably supported
within said handle assembly and interfacing with said actuator
member and said first articulation band assembly such that upon
rotation of said actuator member in a first rotary direction causes
said first articulation band assembly to move in a first axial
direction; and a second articulation disc movably supported within
said handle assembly and interfacing with said actuator member and
said second articulation band assembly such that upon rotation of
said actuator member in said first rotary direction causes said
second articulation disc to move in a second axial direction that
is opposite to said first axial direction.
6. The surgical instrument of claim 5 wherein said first
articulation disc operably interfaces with said actuator member
such that upon rotation of said actuator member in a second rotary
direction causes said first articulation band assembly to move in
said second axial direction and said second articulation band
assembly to move in said first axial direction.
7. The surgical instrument of claim 5 wherein said first and second
articulation discs are in threaded engagement with said actuator
member.
8. The surgical instrument of claim 7 wherein said actuator member
comprises an actuator wheel rotatably supported on said handle
assembly for selective rotation relative thereto about said
actuation axis, said actuator wheel having first threads in
threaded engagement with said first articulation disc and second
threads in threaded engagement with said second articulation, said
first threads having a first thread direction and said second
threads having a second thread direction that is opposite to said
first thread direction.
9. The surgical instrument of claim 1 wherein said surgical end
effector is configured to support an implantable staple cartridge
therein.
10. The surgical instrument of claim 1 further comprising: a knife
bar operably supported by said elongated shaft assembly; a firing
transmission operably supported by said handle assembly; and a
firing trigger operably supported by said handle assembly and
configured to apply actuation motions to said firing transmission
to cause said knife bar to be driven in a distal direction through
said surgical end effector.
11. A surgical cutting and fastening instrument, comprising: an
elongated channel; a surgical staple cartridge operably supported
within said elongated channel; an anvil movably supported relative
to said elongated channel between open and closed positions; a
knife bar supported for movable travel from a proximal end of said
elongated channel to a distal end of said elongated channel upon
application of a firing motion thereto; a handle assembly; an
elongated shaft assembly coupled to said handle assembly and said
elongated channel and operably supporting at least a portion of
said knife bar, said elongated shaft assembly defining a
longitudinal axis and configured to apply said firing motion to
said knife bar; a trigger assembly operably supported on said
handle assembly and configured to apply said firing motion to said
elongated shaft assembly; an articulation system comprising: an
articulation transmission operably supported by said handle
assembly and operably interfacing with said elongated shaft
assembly; and an actuator member rotatably supported on said handle
member for selective rotation about an actuation axis that does not
intersect said longitudinal axis, said actuator member interfacing
with said articulation transmission such that rotation of said
actuator member in a first rotary direction about said actuation
axis causes said elongated shaft assembly to articulate said
surgical end effector relative to said longitudinal axis in a first
articulation direction and rotation of said actuator member in a
second rotary direction about said actuation axis causes said
elongated shaft assembly to articulate said surgical end effector
relative to said longitudinal axis in a second articulation
direction relative to said longitudinal axis.
12. The surgical cutting and fastening instrument of claim 11
wherein said surgical staple cartridge comprises a staple cartridge
assembly that is compressible and implantable.
13. The surgical cutting and fastening instrument of claim 11
wherein said elongated shaft assembly is selectively rotatable
about said longitudinal axis relative to said handle assembly.
14. The surgical cutting and fastening instrument of claim 11
wherein said knife bar comprises: an elongated flexible segment
movably supported within said elongated shaft assembly; a cutting
head coupled to said elongated flexible segment and configured for
axial travel through said elongated channel, said cutting head
having a cutting surface thereon and is configured for compressing
engagement with said anvil as said cutting head is driven from said
a proximal end of said elongated channel to a distal end of said
elongated channel.
15. The surgical cutting and fastening instrument of claim 11
wherein said elongated shaft assembly comprises: a substantially
rigid proximal shaft segment operably interfacing with said handle
assembly; and a substantially flexible articulation joint extending
between said substantially rigid proximal shaft segment and said
elongated channel.
16. The surgical cutting and fastening instrument of claim 15
wherein said elongated shaft assembly further comprises: a first
articulation band assembly operably supported by said substantially
rigid proximal shaft segment and being coupled to one of said
substantially flexible articulation joint and said elongated
channel on a first side of said longitudinal axis and operably
interfacing with said articulation transmission; and a second
articulation band assembly operably supported by said elongated
shaft assembly and coupled to one of said substantially flexible
articulation joint segment and said elongated channel on a second
said of said longitudinal axis, said second articulation band
assembly operably interfacing with said articulation
transmission.
17. The surgical cutting and fastening instrument of claim 16
wherein said articulation transmission comprises: a first
articulation disc movably supported within said handle assembly and
interfacing with said actuator member and said first articulation
band assembly; and a second articulation disc movably supported
within said handle assembly and interfacing with said actuator
member and said second articulation band assembly and wherein:
rotation of said actuator member in said first rotary direction
causes said first and second articulation discs to move axially
toward each other to apply an articulation motion to said first
articulation band assembly in a first axial a first axial direction
and another articulation motion to said second articulation band
assembly in a second axial direction that is opposite to said first
axial direction.
18. The surgical cutting and fastening instrument of claim 17
wherein rotation of said actuator member in said second rotary
direction causes said first and second articulation discs to move
axially away from each other to apply an articulation motion to
said first articulation band assembly in said second axial
direction and another articulation motion to said second
articulation band assembly in said first axial direction.
19. The surgical cutting and fastening instrument of claim 11
further comprising means interacting with said actuator member to
provide a user with an indication that the actuator member is in a
neutral position wherein said surgical end effector is
substantially coaxially aligned on said longitudinal axis.
20. A surgical cutting and fastening instrument, comprising: an end
effector comprising: a channel configured to operably support a
staple cartridge therein; and an anvil movably supported relative
to said channel and wherein said surgical cutting and fastening
instrument further comprises: an elongated shaft assembly defining
a longitudinal axis and comprising: a substantially rigid proximal
shaft segment; a substantially flexible articulation segment
coupled to said substantially rigid distal shaft portion and said
channel of said end effector; a knife bar having a substantially
flexible portion corresponding with said substantially flexible
articulation segment and having a tissue-cutting head formed on a
distal end thereof; a knife tube operably interfacing with said
knife bar to apply actuation motions; a first articulation band
assembly operably supported by said substantially rigid proximal
shaft segment and being coupled to one of said substantially
flexible articulation joint and said channel on a first side of
said longitudinal axis; and a second articulation band assembly
operably supported by said substantially rigid proximal shaft
segment and being coupled to said one of said substantially
flexible articulation joint segment and said elongated channel on a
second side of said longitudinal axis, and wherein said surgical
cutting and fastening instrument further comprises: a handle
assembly operably coupled to said substantially rigid proximal
shaft segment; an actuator wheel rotatably supported on said handle
assembly; a first articulation disc movably supported within said
handle assembly and interfacing with said actuator wheel and said
first articulation band assembly; and a second articulation disc
movably supported within said handle assembly and interfacing with
said actuator wheel and said second articulation band assembly,
said first and second articulation discs configured such that
rotation of said actuator wheel in a first rotary direction causes
said first and second articulation discs to move axially toward
each other to apply an articulation motion to said first
articulation band assembly in a first axial direction and another
articulation motion to said second articulation band assembly in a
second axial direction that is opposite to said first axial
direction; and a firing trigger operably supported on said handle
assembly and interfacing with said knife tube such that application
of an actuation motion to said firing trigger causes said actuation
motion to be applied to said knife tube.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This non-provisional patent application claims priority from
and the benefit of U.S. Provisional Application No. 61/386,094,
filed Sep. 24, 2010, the entire disclosure of which is herein
incorporated by reference.
TECHNICAL FIELD
[0002] The present invention relates to surgical instruments and,
in various embodiments, to hand-actuated surgical cutting and
stapling instruments.
BACKGROUND
[0003] Endoscopic surgical instruments are often preferred over
traditional open surgical devices since a smaller incision tends to
reduce the post-operative recovery time and complications.
Consequently, significant development has gone into a range of
endoscopic surgical instruments that are suitable for precise
placement of a distal end effector at a desired surgical site
through a cannula of a trocar. These distal end effectors engage
the tissue in a number of ways to achieve a diagnostic or
therapeutic effect (e.g., endocutter, grasper, cutter, staplers,
clip applier, access device, drug/gene therapy delivery device, and
energy device using ultrasound, RF, laser, etc.).
[0004] In many endoscopic surgical applications, it is desirable to
employ end effectors that are only as large as necessary to
complete a particular surgical procedure. Smaller end effectors
provide better visualization of the surgical site. Smaller end
effectors also allow for better access and manipulation in tight
spaces. Designers of such end effectors face many challenges when
trying to develop small end effectors. The ability to manufacture
small end effectors and, more particularly, small endocutters that
are designed to cut and staple tissue is hampered by the magnitude
of the actuation forces that are generally required to form lines
of staples and cut tissue. Such actuation forces can also vary with
the thickness and composition of the tissue being treated. For
example, larger actuation forces are commonly required to cut and
staple thick tissues. Whereas, the magnitude of the actuation
forces required to cut and staple thinner tissues in general are
smaller. Thus, many existing endocutters typically employ robust
anvil closure systems and staple driving systems that are
configured to accommodate a specific range of tissue thicknesses.
Such devices, however, are often not well-suited for treating
thinner tissues.
[0005] Prior endocutter devices also generally cut the tissue as
the staples are driven and formed in the tissue on each side of the
cut. While such devices are very effective for those procedures
that require the tissue to be cut and fastened, they do not provide
the surgeon with the option of installing fasteners without cutting
tissue. Likewise, while various forms of articulating endocutters
have been developed to improve access, the components generally
employed in such devices must be substantial enough to accommodate
structures that can generate and transmit sufficient firing and
closure forces to the end effector from the handle of the device.
Thus, such end effectors are often too large to effectively access
tight spaces in the body. Further, there is a need for an end
effector that may be effectively operated with a single hand. There
is also a need for surgical instruments that may address one or
more of the forgoing challenges which can also selectively
articulate the end effector.
[0006] Accordingly, there is a need for surgical cutting and
stapling instruments and staple cartridge arrangements that address
many of the challenges discussed above.
[0007] The foregoing discussion is intended only to illustrate some
of the shortcomings present in the field of the invention at the
time, and should not be taken as a disavowal of claim scope.
SUMMARY
[0008] In accordance with one general form, there is provided a
surgical instrument that comprises a handle assembly and an
elongated shaft assembly that operably interfaces with the handle
assembly and defines a longitudinal axis. A surgical end effector
is operably coupled to the elongated shaft assembly and is
configured to cut and staple tissue upon application of actuation
motions thereto. The surgical instrument further includes at least
one articulation member that is operably supported by the elongated
shaft assembly and an articulation system. In various forms, the
articulation system comprises an articulation transmission that is
operably supported by the handle assembly and operably interfaces
with the at least one articulation member. An actuator member is
rotatably supported on the handle member for selective rotation
about an actuation axis that does not transversely intersect the
longitudinal axis. The actuator member interfaces with the
articulation transmission such that rotation of the actuator member
in a first rotary direction about the actuation axis causes the at
least one articulation member to articulate the surgical end
effector relative to the longitudinal axis in a first articulation
direction and rotation of the actuator member in a second rotary
direction about the actuation axis causes the at least one
articulation member to articulate the surgical end effector
relative to the longitudinal axis in a second articulation
direction relative to the longitudinal axis.
[0009] In accordance with another general form, there is provided a
surgical cutting and fastening instrument that includes an
elongated channel that operably supports a surgical staple
cartridge. An anvil is movably supported relative to the elongated
channel between open and closed positions. A knife bar is supported
for movable travel from a proximal end of the elongated channel to
a distal end of the elongated channel upon application of a firing
motion thereto. A handle assembly has an elongated shaft assembly
coupled thereto that is also coupled to the elongated channel. The
handle assembly operably supports at least a portion of the knife
bar. The elongated shaft assembly defines a longitudinal axis and
is configured to apply the firing motion to the knife bar. A
trigger assembly is operably supported on the handle assembly and
is configured to apply the firing motion to the elongated shaft
assembly. The surgical instrument further comprises an articulation
system that includes an articulation transmission that is operably
supported by the handle assembly and operably interfaces with the
elongated shaft assembly. An actuator member is rotatably supported
on the handle member for selective rotation about an actuation axis
that does not intersect the longitudinal axis. The actuator member
interfaces with the articulation transmission such that rotation of
the actuator member in a first rotary direction about the actuation
axis causes the elongated shaft assembly to articulate the surgical
end effector relative to the longitudinal axis in a first
articulation direction and rotation of the actuator member in a
second rotary direction about the actuation axis causes the
elongated shaft assembly to articulate the surgical end effector
relative to the longitudinal axis in a second articulation
direction relative to the longitudinal axis.
[0010] In accordance with still another general form, there is
provided a surgical cutting and fastening instrument. In at least
one form, the instrument comprises an end effector that has a
channel that is configured to operably support a staple cartridge
therein. An anvil is movably supported relative to the channel. The
instrument further comprises an elongated shaft assembly that
defines a longitudinal axis and includes a substantially rigid
proximal shaft segment. A substantially flexible articulation
segment is coupled to the substantially rigid distal shaft portion
and the channel of the end effector. The elongated shaft assembly
further comprises a knife bar that has a substantially flexible
portion that corresponds with the substantially flexible
articulation segment and has a tissue-cutting head formed on a
distal end thereof. A knife tube operably interfaces with the knife
bar to apply actuation motions. A first articulation band assembly
is operably supported by the substantially rigid proximal shaft
segment and is coupled to one of the substantially flexible
articulation joint and the channel on a first side of the
longitudinal axis. A second articulation band assembly is operably
supported by the substantially rigid proximal shaft segment and is
coupled to one of the substantially flexible articulation joint
segment and the elongated channel on a second side of the
longitudinal axis. In at least one form, the surgical cutting and
fastening instrument further comprises a handle assembly that is
operably coupled to the substantially rigid proximal shaft segment.
An actuator wheel is rotatably supported on the handle assembly. A
first articulation disc is movably supported within the handle
assembly and interfaces with the actuator wheel and the first
articulation band assembly. A second articulation disc is movably
supported within the handle assembly and interfaces with the
actuator wheel and the second articulation band assembly. The first
and second articulation discs are configured such that rotation of
the actuator wheel in a first rotary direction causes the first and
second articulation discs to move axially toward each other to
apply an articulation motion to the first articulation band
assembly in a first axial direction and another articulation motion
to the second articulation band assembly in a second axial
direction that is opposite to the first axial direction. A firing
trigger is operably supported on the handle assembly and interfaces
with the knife tube such that application of an actuation motion to
the firing trigger causes the actuation motion to be applied to the
knife tube.
BRIEF DESCRIPTION OF DRAWINGS
[0011] The above-mentioned and other features and advantages of
this invention, and the manner of attaining them, will become more
apparent and the invention itself will be better understood by
reference to the following description of embodiments of the
invention taken in conjunction with the accompanying drawings,
wherein:
[0012] FIG. 1 is a perspective view of one surgical instrument
embodiment of the present invention;
[0013] FIG. 2 is another perspective view of the surgical
instrument of FIG. 1, with a handle case removed from the handle
assembly;
[0014] FIG. 3 is an exploded assembly view of the surgical
instrument embodiment of FIGS. 1 and 2;
[0015] FIG. 4 is an exploded assembly view of a portion of the
shaft assembly and end effector of the surgical instrument
embodiment depicted in FIGS. 1-3;
[0016] FIG. 5 is another exploded assembly view of another portion
of the shaft assembly and end effector of FIG. 4;
[0017] FIG. 6 is a partial cross-sectional view of an end effector
and portion of a shaft assembly embodiment of the present
invention;
[0018] FIG. 7 is a partial cross-sectional perspective view of a
portion of the end effector and shaft assembly of FIG. 6;
[0019] FIG. 8 is another perspective view of the surgical
instrument of FIGS. 1-3 with a handle casing and outer shaft
members removed for clarity;
[0020] FIG. 9 is a top view of a portion of the surgical instrument
of FIG. 8 in an unarticulated position;
[0021] FIG. 10 is another top view of the portion of the surgical
instrument of FIG. 9 in a first articulated position;
[0022] FIG. 11 is another top view of the portion of the surgical
instrument of FIGS. 9 and 10 in a second articulated position;
[0023] FIG. 12 is a right side view of the surgical instrument
embodiment of FIG. 8 with the left side handle casing removed and
the end effector thereof in an open position;
[0024] FIG. 13 is a left side view of the surgical instrument
embodiment of FIG. 12 with the right side handle casing
removed;
[0025] FIG. 14 is a partial rear perspective view of the surgical
instrument embodiment of FIG. 13;
[0026] FIG. 15 is another partial rear perspective view of the
surgical instrument embodiment of FIGS. 13 and 14;
[0027] FIG. 16 is a right side view of the surgical instrument
embodiment of FIGS. 12-15 with the left side handle casing removed
and illustrating an initial actuation of the trigger assembly
thereof to close the end effector;
[0028] FIG. 17 is a left side view of the surgical instrument
embodiment of FIG. 16 with the right side handle casing
removed;
[0029] FIG. 18 is a partial rear perspective view of the surgical
instrument embodiment of FIG. 17;
[0030] FIG. 19 is another partial rear perspective view of the
surgical instrument embodiment of FIGS. 17 and 18;
[0031] FIG. 20 is a right side view of the surgical instrument
embodiment of FIGS. 12-19 with the left side handle casing removed
and illustrating the end effector locked in the closed
position;
[0032] FIG. 21 is a left side view of the surgical instrument
embodiment of FIG. 20 with the right side casing removed;
[0033] FIG. 22 is a partial rear perspective view of the surgical
instrument embodiment of FIG. 21;
[0034] FIG. 23 is another partial rear perspective view of the
surgical instrument embodiment of FIGS. 21 and 22;
[0035] FIG. 24 is a right side view of the surgical instrument
embodiment of FIGS. 12-23 with the left side handle casing removed
and illustrating the trigger assembly illustrating a second
actuation of the trigger assembly to apply the second actuation
motion to the end effector;
[0036] FIG. 25 is a left side view of the surgical instrument
embodiment of FIG. 24 with the right side casing removed;
[0037] FIG. 26 is a partial rear perspective view of the surgical
instrument embodiment of FIG. 25;
[0038] FIG. 27 is another partial rear perspective view of the
surgical instrument embodiment of FIGS. 25 and 26;
[0039] FIG. 28 is another right side view of the surgical
instrument embodiment of FIGS. 12-27 with the left side handle
casing removed and illustrating the trigger assembly after the
surgeon has released it after applying the second actuation motion
to the end effector;
[0040] FIG. 29 is a left side view of the surgical instrument
embodiment of FIG. 28 with the right side casing removed;
[0041] FIG. 30 is a partial rear perspective view of the surgical
instrument embodiment of FIG. 29;
[0042] FIG. 31 is another partial rear perspective view of the
surgical instrument embodiment of FIGS. 29 and 30;
[0043] FIG. 32 is another right side view of the surgical
instrument embodiment of FIGS. 12-31 with the left side handle
casing removed and illustrating the trigger assembly after the
secondary trigger has been returned to its starting position;
[0044] FIG. 33 is a left side view of the surgical instrument
embodiment of FIG. 32 with the right side casing removed;
[0045] FIG. 34 is a perspective view of another surgical instrument
embodiment of the present invention;
[0046] FIG. 35 is another perspective view of the surgical
instrument of FIG. 34 with a handle casing removed for clarity;
[0047] FIG. 36 is an exploded perspective assembly view of the
surgical instrument of FIGS. 34 and 35;
[0048] FIG. 37 is a partial exploded perspective view of an end
effector and portion of an elongated shaft assembly embodiment of
various surgical instrument embodiments of the present
invention;
[0049] FIG. 38 is a side elevational view of a surgical instrument
embodiment of the present invention with a portion of the handle
housing omitted for clarity and showing the end effector thereof in
an open position;
[0050] FIG. 39 is another side elevational view of the surgical
instrument embodiment of FIG. 38 with a portion of the handle
housing omitted for clarity and showing the end effector upon
initial application of an actuation force to the firing
trigger;
[0051] FIG. 40 is another side elevational view of the surgical
instrument embodiment of FIGS. 38 and 39 with a portion of the
handle housing omitted for clarity and showing the end effector
upon further application of the actuation force to the firing
trigger;
[0052] FIG. 41 is another side elevational view of the surgical
instrument embodiment of FIGS. 38-40 with a portion of the handle
housing omitted for clarity and showing the end effector upon
actuation of the locking trigger;
[0053] FIG. 42 is another side elevational view of the surgical
instrument embodiment of FIGS. 38-41 with a portion of the handle
housing omitted for clarity and showing the end effector upon
complete actuation of the firing trigger;
[0054] FIG. 43 is a top cross-sectional view of a surgical
instrument embodiment of the present invention in a neutral
articulation position;
[0055] FIG. 44 is a side elevational view of the surgical
instrument of FIG. 43 with a portion of the handle housing omitted
for clarity;
[0056] FIG. 45 is a top cross-sectional view of a surgical
instrument embodiment of FIGS. 43 and 44 with the end effector
thereof articulated in a first articulation direction relative to
the longitudinal axis;
[0057] FIG. 46 is a side elevational view of the surgical
instrument of FIG. 45 with a portion of the handle housing omitted
for clarity;
[0058] FIG. 47 is a top cross-sectional view of a surgical
instrument embodiment of FIGS. 43-46 with the end effector thereof
articulated in a second articulation direction relative to the
longitudinal axis; and
[0059] FIG. 48 is a side elevational view of the surgical
instrument of FIG. 47 with a portion of the handle housing omitted
for clarity.
[0060] Corresponding reference characters indicate corresponding
parts throughout the several views. The exemplifications set out
herein illustrate preferred embodiments of the invention, in one
form, and such exemplifications are not to be construed as limiting
the scope of the invention in any manner.
DETAILED DESCRIPTION
[0061] The Applicant of the present application also owns the U.S.
patent applications identified below which were filed on even date
herewith and which are each herein incorporated by reference in
their respective entirety: [0062] U.S. patent application Ser. No.
______, entitled "Surgical Instrument With Trigger Assembly For
Generating Multiple Actuation Motions", Attorney Docket No.
END6888USNP3/110378; [0063] U.S. patent application Ser. No.
______, entitled "Surgical Stapler With Stationary Staple Drivers",
Attorney Docket No. END7013USNP/110377; [0064] U.S. patent
application Ser. No. ______, entitled "Surgical Stapler With
Floating Anvil", Attorney Docket No. END6841USCIP2/100526CIP2;
[0065] U.S. patent application Ser. No. ______, entitled "Staple
Cartridge Including Collapsible Deck Arrangement", Attorney Docket
No. END7019USNP/110375; [0066] U.S. patent application Ser. No.
______, entitled "Staple Cartridge Including Collapsible Deck",
Attorney Docket No. END7020USNP/110374; and [0067] U.S. patent
application Ser. No. ______, entitled "Curved End Effector For A
Stapling Instrument", Attorney Docket No.
END6841USCIP3/100526CIP3.
[0068] Certain exemplary embodiments will now be described to
provide an overall understanding of the principles of the
structure, function, manufacture, and use of the devices and
methods disclosed herein. One or more examples of these embodiments
are illustrated in the accompanying drawings. Those of ordinary
skill in the art will understand that the devices and methods
specifically described herein and illustrated in the accompanying
drawings are non-limiting exemplary embodiments and that the scope
of the various embodiments of the present invention is defined
solely by the claims. The features illustrated or described in
connection with one exemplary embodiment may be combined with the
features of other embodiments. Such modifications and variations
are intended to be included within the scope of the present
invention.
[0069] Reference throughout the specification to "various
embodiments," "some embodiments," "one embodiment," or "an
embodiment", or the like, means that a particular feature,
structure, or characteristic described in connection with the
embodiment is included in at least one embodiment. Thus,
appearances of the phrases "in various embodiments," "in some
embodiments," "in one embodiment", or "in an embodiment", or the
like, in places throughout the specification are not necessarily
all referring to the same embodiment. Furthermore, the particular
features, structures, or characteristics may be combined in any
suitable manner in one or more embodiments. Thus, the particular
features, structures, or characteristics illustrated or described
in connection with one embodiment may be combined, in whole or in
part, with the features structures, or characteristics of one or
more other embodiments without limitation. Such modifications and
variations are intended to be included within the scope of the
present invention.
[0070] The terms "proximal" and "distal" are used herein with
reference to a clinician manipulating the handle portion of the
surgical instrument. The term "proximal" referring to the portion
closest to the clinician and the term "distal" referring to the
portion located away from the clinician. It will be further
appreciated that, for convenience and clarity, spatial terms such
as "vertical", "horizontal", "up", and "down" may be used herein
with respect to the drawings. However, surgical instruments are
used in many orientations and positions, and these terms are not
intended to be limiting and/or absolute.
[0071] Various exemplary devices and methods are provided for
performing laparoscopic and minimally invasive surgical procedures.
However, the person of ordinary skill in the art will readily
appreciate that the various methods and devices disclosed herein
can be used in numerous surgical procedures and applications
including, for example, in connection with open surgical
procedures. As the present Detailed Description proceeds, those of
ordinary skill in the art will further appreciate that the various
instruments disclosed herein can be inserted into a body in any
way, such as through a natural orifice, through an incision or
puncture hole formed in tissue, etc. The working portions or end
effector portions of the instruments can be inserted directly into
a patient's body or can be inserted through an access device that
has a working channel through which the end effector and elongated
shaft of a surgical instrument can be advanced.
[0072] Turning to the Drawings wherein like numerals denote like
components throughout the several views, FIG. 1 depicts a surgical
instrument 10 that is capable of practicing several unique benefits
of the present invention. The surgical instrument 10 is designed to
manipulate and/or actuate various forms and sizes of end effectors
12 that are operably attached thereto. In the depicted embodiment,
for example, the end effector 12 comprises a surgical stapling
device that has openable and closable jaws 13 and 15. More
specifically, the end effector 12 includes an elongated channel 14
that forms a lower jaw 13 of the end effector 12. The elongated
channel 14 is configured to support a staple cartridge 30 and also
movably supports an anvil 20 that functions as an upper jaw 15 of
the end effector 12. The end effector 12 may comprise, for example,
an end effector of the types disclosed in co-pending U.S. patent
application Ser. No. ______, entitled "Curved End Effector For A
Stapling Instrument", Attorney Docket No. END6841USCIP3/100526CIP3,
U.S. patent application Ser. No. ______, entitled "Surgical Stapler
With Floating Anvil", Attorney Docket No. END6841USCIP2/100526CIP2,
and U.S. patent application Ser. No. ______, entitled "Surgical
Stapler With Stationary Staple Drivers", Attorney Docket No.
END7013USNP/110377, the entire disclosures of each which have been
herein incorporated by reference. However, it is conceivable that
the surgical instrument 10 may be employed to activate a variety of
different surgical end effectors that require at least two
actuation motions to perform one or more surgical
activities/actions. For example, the unique and novel features of
various embodiments may be successfully employed in connection with
those end effectors that are configured to apply radio frequency
"RF" energy to tissue clamped or otherwise engaged therein. Thus,
the various embodiment of the surgical instruments disclosed herein
should not be limited to use solely in connection with the types
and forms of end effector depicted in the appended Figures.
[0073] In various implementations, the end effector 12 is
configured to be operably coupled to an elongated shaft assembly
100 that protrudes from a handle assembly 400. The end effector 12
(when closed) and the elongated shaft assembly 100 may have similar
cross-sectional shapes and be sized to operably pass through a
trocar tube or working channel in another form of access
instrument. As used herein, the term "operably pass" means that the
end effector 12 and at least a portion of the elongated shaft
assembly 100 may be inserted through or passed through the channel
or tube opening and can be manipulated therein as needed to
complete the surgical procedure. In some embodiments, when in a
closed position, the jaws 13 and 15 of the end effector 12 may
provide the end effector with a roughly circular cross-sectional
shape that facilitates its passage through a circular
passage/opening. However, the end effectors of various embodiments
of the present invention, as well as the elongated shaft assembly
embodiments, could conceivably be provided with other
cross-sectional shapes that could otherwise pass through access
passages and openings that have non-circular cross-sectional
shapes. Thus, an overall size of a cross-section of a closed end
effector will be related to the size of the passage or opening
through which it is intended to pass. Thus, one end effector for
example, may be referred to as a "5 mm" end effector which means it
can operably pass through an opening that is at least approximately
5 mm in diameter.
[0074] In various embodiments, the elongated shaft assembly 100 may
have an outer diameter that is substantially the same as the outer
diameter of the end effector 12 when in a closed position. For
example, a 5 mm end effector may be coupled to an elongated shaft
assembly 100 that has 5 mm cross-sectional diameter. However, as
the present Detailed Description proceeds, it will become apparent
that various embodiments of the present may be effectively used in
connection with different sizes of end effectors. For example, a 10
mm end effector may be attached to an elongated shaft that has a 5
mm cross-sectional diameter. Conversely, for those applications
wherein a 10 mm or larger access opening or passage is provided,
the elongated shaft assembly 100 may have a 10 mm (or larger)
cross-sectional diameter, but may also be able to actuate a 5 mm or
10 mm end effector. Accordingly, the elongated shaft assembly 100
may have an outer diameter that is the same as or is different from
the outer diameter of a closed end effector 12 attached
thereto.
[0075] The elongated shaft assembly 100 may be similar in
construction to those articulatable shaft arrangements described in
U.S. Pat. No. 5,713,505 to Huitema and U.S. Pat. No. 5,704,534 to
Huitema et al., the entire disclosures of which are each herein
incorporated by reference in their respective entireties. Referring
to FIGS. 1 and 2, in at least one form, the surgical instrument 10
has an articulation transmission 200 that couples the elongated
shaft assembly 100 to the handle assembly 300. However, as the
present Detailed Description proceeds, those of ordinary skill in
the art will understand that various unique and novel features of
the present invention may be employed in connection with elongated
shaft assembly arrangements that are not articulatable.
[0076] When the articulation transmission assembly 200 is actuated,
it causes the remote articulation of the end effector 12 relative
to the longitudinal axis L-L defined by the elongated shaft
assembly 100. In at least one form, the elongated shaft assembly
100 includes a flexible neck assembly 110. Various flexible neck
assemblies are disclosed in U.S. Provisional Patent Application
Ser. No. 61/386,117, filed Sep. 24, 2010, the entire disclosure of
which is herein incorporated by reference. The flexible neck
assembly 110 may be composed of a rigid thermoplastic polyurethane
sold commercially as ISOPLAST grade 2510 by the Dow Chemical
Company. The flexible neck assembly 110 has flexible neck segment
111 that comprises first and second flexible neck portions, 112 and
114. These neck portions 112, 114 are separated by a central
longitudinal rib 116. The neck portions 112, 114 each have a
plurality of neck ribs 118 configured essentially as semi-circular
disks which together generally form a cylindrical configuration. A
side slot 120 extends through each of the neck ribs 118 to provide
a passage through the first and second flexible neck portions 112,
114 for receiving flexible transmission band assemblies 150, 170.
See, for example, FIG. 7. In a similar fashion, the central
longitudinal rib 116 that separates the first and second flexible
neck portions 112, 114 has a central longitudinal slot 122 for
providing a passage to receive a knife bar 180.
[0077] First and second support guide surfaces 124 and 126 extend
proximally from the flexible neck segment 111 for supporting the
reciprocating movement of the flexible transmission band assemblies
150, 170. As can be seen in FIG. 4, a channel guide 128 extends
from the distal end of the flexible neck segment 111 for guiding
the reciprocatable movement of the knife bar 180 as will be
discussed in further detail below.
[0078] As can be seen in FIG. 3, the first transmission band
assembly 150 includes a first transmission band 152 and the second
transmission band assembly 170 includes a second transmission band
172. In addition, the first transmission band 150 has a first
elongated structural portion 154 and the second transmission band
170 has a second elongated structural portion 174. When the first
and second transmission bands 150, 170 are brought into contact
with each other during assembly of the instrument, they form an
elongated cylinder which has a longitudinal cavity 160 extending
concentrically through it to operably receive a firing rod 530
therethrough. The first structural portion 154 of the first
transmission band 152 has a first articulation rack 156 formed
thereon and the second structural portion 174 of the second
transmission band 172 has a second articulation rack 176 formed
thereon which, as will be discussed in further detail below,
drivingly interface with articulation transmission assembly
200.
[0079] Also in various forms, the first transmission band 152 has a
first exterior reinforcement band portion 157 that extends distally
from the first structural portion 156. See FIG. 3. Likewise, the
second transmission band 172 has a second exterior reinforcement
band portion 177 that extends distally from the second structural
portion 176. Each exterior reinforcement band portion 157, 177 has
a plurality of attachment lugs 162 for securing first and second
interior articulation bands thereto. For example, the first
transmission band 152 has a first interior articulation band 158
attached thereto and the second transmission band 172 has a second
interior articulation band 178 attached thereto. The first and
second transmission bands 152, 172 may be composed of a plastic,
especially a glass fiber-reinforced amorphous polyamide, sold
commercially under the trade name Grivory GV-6H by EMS-American
Grilon. In contrast, the interior articulation bands 158, 178 of
the transmission band assembly may be composed of a metal,
advantageously full hard 301 stainless steel or its equivalent. The
attachment lugs 162 on the exterior reinforcement band portions
157, 177 of the transmission bands 152, 172, respectively, are
received into and secured within a plurality of lug holes 164 on
the corresponding interior articulation band 158, 178. See FIG.
3.
[0080] In at least one embodiment, the proximal end of the
elongated cartridge channel 14 is provided with a pair of band
connector ears 50. These band connector ears 50 are inserted into
and through connector loops 159, 179 on the distal end of the
interior articulation bands 158, 178, respectively. In this manner,
the cartridge channel 14, which operably supports a staple
cartridge 30 is coupled to the interior articulation bands 158, 178
of the flexible neck assembly 110. Specifically, the reciprocation
of the first and second flexible transmission band assemblies 150,
170 in opposite directions causes the interior articulation bands
158, 178 received in the side slots 120 of the neck ribs 118 on the
flexible neck segment 111 to reciprocate in a like manner. Upon
reciprocation of the interior articulation bands 158, 178, in
particular when the first band 158 is moved proximally in tandem
with the second band 178 moving distally, the first and second
flexible neck portions 114, 116 bend as the neck ribs 118 of the
first flexible neck portion 114 move toward each other and the neck
ribs 118 of the second flexible neck rib portion 116 concurrently
move away from each other. The coupling of the interior
articulation bands 158, 178 to the exterior reinforcement band
portions 157, 177 of the transmission bands 152, 172, respectively
prevents the interior articulation bands 158, 178 from buckling
between adjacent neck ribs.
[0081] Movement of the first and second transmission bands 152, 172
is controlled by the articulation transmission 200. The component
parts of one form of the articulation transmission assembly 200 are
illustrated in FIG. 3. The assembly 200 includes an actuator 210,
an articulation body 220 and a nozzle 250. Rotational movement of
the actuator 210 causes corresponding rotation of the articulation
body 220 within the nozzle 250. The first and second elongated
transmission bands, 152 and 172, consequently reciprocate axially
in opposite directions parallel to the longitudinal axis L-L of the
elongated shaft assembly 100 to cause the remote articulation of
the end effector 12.
[0082] In various embodiments, the articulation body 220 has a deck
222 consisting of first and second spaced-apart, semicircular deck
halves, 224, 226. The deck halves are mutually opposed to each
other and essentially represent mirror images of each other. The
first and second deck halves 224, 226 have protruding from their
surfaces mutually opposed first and second detents 225, 227,
respectively. Each deck half 224, 226 has a set of deck teeth 228
spaced about 180 degrees from the set of deck teeth on the other
deck half. The articulation body 220 has a pair of rotation stops
230 descending from its surface as well as a pair of finger
recesses 232. A drive gear 240 descends from the articulation body
22. The drive gear 240 has a flared opening 242 through it, and a
lower pivot 244. Within the flared opening 242 of the drive gear
240, there is a firing rod orifice (not shown) for receiving the
firing rod 550 therethrough enabling the application of a firing
motion to the end effector 12. The drive gear 240 is configured to
intermesh with the first and second drive racks 156, 176,
respectively to effect the desired reciprocating movement of the
first and second transmission bands 152, 172.
[0083] The nozzle 250 of the articulation transmission assembly 200
includes a nozzle body 252. The nozzle body 252 has an axial bore
254 therethrough that facilitates the passage of the first
transmission band assembly 150 and the second transmission band
assembly 170 as well as for the firing rod 530 and other operative
components of the instrument 10. The nozzle body 252 also has a
frame groove 256 and flange 258 to fasten the nozzle body 252 to
the handle assembly 300 (see FIG. 8). In various forms, a detent
housing 260 comprises a portion of the nozzle body 252. An annular
array of detent teeth 262 is formed within the detent housing 260.
A detent housing floor 264 is spaced from the detent teeth 262. The
floor 264 has a pair of ledges 266 which interact within the
rotation stops 230 of the articulation body 220 to limit the degree
of rotation. When the articulation body 220 is inserted into the
detent housing 260, the base of the articulation body 220 is
supported on the floor 264 within the detent housing 260, and the
deck teeth 228 of the first and second deck halves, 224, 226 are
aligned for meshing engagement with the detent teeth 262 of the
detent housing 260. A spring member 268 is supported within the
articulation body to bias the deck teeth 228 into meshing
engagement with the detent teeth 262.
[0084] In various forms, the actuator 210 consists of a lever arm
212, a cap 214 and a pair of retaining fingers 216. The lever arm
212 is mounted on the top of the cap 214. The pair of retaining
fingers 216 descend downwardly from the underside of the cap 214.
Each of the retaining fingers 216 has a retaining clip. The
retaining fingers 216 are received within the finger recesses 232
of the articulation body 220. The first and second detents, 225,
227, of the deck halves of the articulation body are inserted into
a slot depression within the underside of the circular cap 214.
Advantageously, each of the three significant components of the
articulation transmission assembly, namely the actuator,
articulation body and nozzle, may be injection molded components.
Such components, for example, may be fabricated from a glass
fiber-reinforced amorphous polyamide, sold commercially under the
trade name Grivory GV-4H by EMS--American Grilon. 150.
[0085] FIG. 3, in combination with FIGS. 9-11, illustrate the
actuation of the articulation transmission assembly 200. Ratcheting
rotation of the actuator 210 causes articulation of the end
effector 12 in a plurality of discrete positions angled from the
longitudinal axis L-L of the endoscopic shaft assembly 100. FIG. 9
illustrates the end effector 12 in an unarticulated position. In
FIG. 10, the drive gear 240 on the articulation body 220 of the
articulation transmission 200 has been rotated to drive the first
transmission band assembly 150 distally in the "DD" direction and
the second transmission bar assembly 170 proximally in the proximal
direction "PD" which causes the end effector 12 to articulate in a
first direction "FD" relative to the longitudinal axis L-L. In FIG.
11, the drive gear 240 on the articulation body 220 of the
articulation transmission 200 has been rotated to drive the second
articulation band assembly 170 in the distal direction "DD" and the
first articulation band assembly 150 in the proximal direction "PD"
to cause the end effector 12 to pivot in a second direction "SD"
relative to the longitudinal axis L-L.
[0086] As can be seen in FIGS. 3-7, the elongated shaft assembly
100 further includes a distal closure tube segment 190 that is slid
over the channel guide 128 of the flexible neck assembly 110. The
proximal end 191 of the distal closure tube segment 190 has a pair
of diametrically opposed slots 192 therein for receiving distally
protruding lugs 113 protruding from the flexible neck portion 111
to prevent rotation of the distal closure tube segment 190 relative
to the flexible neck portion 111. In various embodiments, a
fastener hole 129 is provided in the channel guide 128. The distal
closure tube segment 190 is retained on the channel guide 128 by a
retention tab 193 that extends into the fastener hole 129. See
FIGS. 6 and 7. Such arrangement causes the closure tube segment 190
to move axially with the flexible neck assembly 110. Movement of
the closure tube segment 190 distally into contact with the anvil
20 causes the anvil 20 to move to a closed position as described in
further detail in co-pending U.S. patent application Ser. No.
______, entitled "Surgical Stapler With Floating Anvil", Attorney
Docket No. END6841USCIP2/100526CIP2, the entire disclosure of which
has been incorporated by reference herein.
[0087] As described in further detail in the above-referenced
patent application, the anvil 20 has a mounting portion 22 that
protrudes from its proximal end 21. The mounting portion 22 has a
pair of trunnion pivots 24 thereon that are configured to be
pivotally received in corresponding cradles 15 in the elongated
channel 14. See FIGS. 5-7. For assembly purposes, the distal
closure tube segment 190 is provided with a bottom slit 195. To
assemble the anvil 20 to the elongated channel 14, the trunnion
pivots 24 are placed in the corresponding cradles 15 in the
elongated channel 14 and the distal closure tube segment 190 is
then snapped onto the channel guide 128. Such arrangement serves to
movably retain the anvil 20 on the elongated channel 14 and
facilitates its movement relative to the staple cartridge 30. In
various implementations, the anvil 20 may be moved towards the
surgical staple cartridge 30 by axially advancing the distal
closure tub segment 190 in the distal direction "DD" to bring the
distal end 196 of the closure tube segment 190 into contact with
the proximal end 21 of the anvil 20. Prior to firing (distally
advancing) the knife bar 180, the anvil 20 may be pivoted to the
open position (FIG. 6) by axially advancing the distal closure tube
segment 190 in the proximal direction "PD" as will be discussed in
further detail below. Such actuation of the anvil 20 is
accomplished by a distal tab 196 on the distal closure tube segment
190 that extends into an elongated slot 25 in the anvil mounting
portion 22. As the distal tab 196 is drawn proximally in the slot
25, it eventually contacts the proximal end wall of the slot 25 and
causes the anvil 20 to move to the open position.
[0088] As can be seen in FIGS. 3 and 6, the elongated shaft
assembly 100 further includes a proximal outer shaft segment 300
that is attached to the flexible neck assembly 110. The proximal
outer shaft segment 300 is substantially rigid and may be attached
to the flexible neck portion 111 of the flexible neck assembly 110
by, for example, a press fit, adhesive or other suitable fastener
arrangement. As can be seen in FIG. 3, in at least one embodiment,
the distal end 302 of the proximal outer shaft segment 300 has a
pair of opposed notches 304 therein that are adapted to receive
corresponding lugs 115 protruding from the flexible neck portion
111 such that rotation of the proximal outer shaft segment 300
results in rotation of the flexible neck assembly 110 and
ultimately of the end effector 12.
[0089] In at least one embodiment, the proximal outer shaft segment
300 has a proximal end 306 that has a slot 308 for receiving the
drive gear 240 therethrough such that the proximal outer shaft
segment 300 may move axially relative thereto. In addition, the
proximal end 306 of the proximal outer shaft segment 300 has a
flange 310 formed thereon that facilitates rotational attachment to
a closure carriage 420 of an actuation system 410 that is operably
supported within the handle assembly 400. In various embodiments,
the closure carriage 420 may comprise two carriage segments 422
that are interconnected together by adhesive, snap features,
screws, etc. As can be seen in FIG. 3, in at least one form, the
closure carriage 420 has a distal end 424 that has a groove
arrangement 426 that is adapted to receive the flanged end 310 of
the proximal outer shaft segment 300. Such arrangement serves to
attach the proximal end 306 of the proximal outer shaft segment 300
to the closure carriage 420 while facilitating its selective
rotation of the proximal outer shaft segment 300 relative to the
closure carriage 420. Therefore, the elongated shaft assembly 100
and the end effector 12 that is operably coupled thereto may be
selectively rotated about the longitudinal axis L-L relative to the
handle assembly 400.
[0090] In various embodiments, the handle assembly 400 comprises a
pistol-shaped housing that may be fabricated in two or more pieces
for assembly purposes. For example, the handle assembly 400 as
shown comprises a right hand case member 402 and a left hand case
member 404 (FIG. 1) that are molded or otherwise fabricated from a
polymer or plastic material and are designed to mate together. Such
case members 402 and 404 may be attached together by snap features,
pegs and sockets molded or otherwise formed therein and/or by
adhesive, screws, etc. When assembled, the handle assembly 400
movably supports the closure carriage 420 for selective axial
travel therein in response to actuation motions from a trigger
assembly, generally designated as 430.
[0091] In at least one embodiment, the trigger assembly 430
comprises a primary trigger 440 and a secondary trigger 460. The
primary and secondary triggers 440 and 460 are pivotally journaled
on a pivot pin assembly 430 formed in the handle assembly 400 such
that the triggers 440 and 460 may essentially move relative to each
other. Such arrangement permits the trigger assembly 430 to pivot
relative to the handle assembly 400 about pivot axis PA-PA. See
FIG. 3. The primary trigger 440 has an elongated, grippable primary
trigger paddle 442 that protrudes from a primary drive portion 444
that has a firing rack 446 formed thereon. In one embodiment, the
secondary trigger 460 has a secondary trigger paddle 462 that
protrudes from a secondary drive portion 464 that is pivotally
journaled on the pivot pin assembly 430. The primary drive portion
444 has a slot 448 that is adapted to receive the secondary drive
portion 464 of the secondary trigger 460 therein as the primary
trigger paddle 442 is pivoted towards a pistol grip portion 406 of
the handle assembly 400. Such arrangement essentially enables the
secondary trigger 460 to "nest" within the primary trigger 440
during actuation. As will be discussed in detail below, the
secondary trigger 460 is pivotally actuated by pivoting the primary
trigger 440. Thus, in other embodiments, the secondary trigger 460
may lack the secondary trigger paddle 442. In various forms, the
trigger assembly 430 is biased into the unactuated position shown
in FIGS. 1, 2, 8, and 12-15 by a trigger spring 432 (shown in FIGS.
3, 8, 12, and 13).
[0092] As can be seen in FIGS. 3 and 13, the secondary drive
portion 464 of the secondary trigger 460 has a closure gear segment
466 formed thereon that is configured for meshing engagement with a
carriage gear rack 423 formed on the underside of the closure
carriage 420. Thus, when the secondary trigger 460 is pivoted
toward the pistol grip 406, the closure carriage 420 is driven in
the distal direction "DD".
[0093] In various embodiments, the actuation system 410 further
includes an actuation bar 470. The actuation bar 470 has a first
actuation rack 472 formed thereon that is configured for meshing
engagement with the primary gear segment 446 on the primary trigger
440. Thus, when the primary gear segment 446 is in meshing
engagement with the first actuation rack 472, the actuation bar 470
is driven in the distal direction "DD" when the primary trigger 440
is pivoted toward the pistol grip 406. As can also be seen in FIGS.
3, 8, and 12, the actuation bar 470 has a second actuation rack 474
formed thereon configured to meshingly engage clutch teeth 484 on a
clutch shaft 482 of a clutch assembly 480. In various embodiments,
the clutch shaft 482 is rotatably is supported within the handle
assembly 400 and is also laterally movable therein. The clutch
shaft 482 has a hub portion 486 that has a plurality of spaced
teeth 488 that are configured to drivingly engage teeth openings
492 in a drive gear 490 that is rotatably supported on the clutch
shaft 482. The drive gear 490 has a segment of drive gears 494 on a
portion of its circumference that are adapted for meshing
engagement with a firing rack 500 that is movably supported in the
handle assembly 400.
[0094] Various embodiments of the clutch assembly 480 further
comprise a clutch plate 510 that is slidably journaled on a clutch
pin 449 provided on the primary drive portion 444 of the primary
trigger 440. As can be seen in FIGS. 13 and 15, for example, the
clutch pin 449 is movably received within a vertical slot 512 in
the clutch plate 510. The clutch plate 510 also has a
distally-extending clutch arm 514 that is adapted to actuatably
engage a bevel plate 489 formed on the clutch shaft 482. In
addition, a clutch spring 520 is employed to bias the clutch shaft
480 laterally such that the teeth 488 on the clutch shaft 482 are
brought into meshing engagement with the teeth openings 492 in the
drive gear 490.
[0095] As can be seen in FIG. 3, the firing rack 500 is coupled to
a firing rod 530 that is attached to the proximal end of the knife
bar 180. In various embodiments, the knife bar 180 may be of
laminated construction to enable it to flex as the end effector 12
is articulated, while remaining sufficiently rigid to be driven
distally through the shaft assembly 100. In the depicted
embodiment, the knife bar 180 terminates in an E-beam cutting head
182 that has a tissue-cutting surface 184 thereon. A variety of
forms of cutting head configurations are known and may be
employed--depending upon the particular configuration of end
effector used. The depicted embodiment, for example, includes upper
guide fins 186 that are configured to enter corresponding slots in
the anvil 20 to verify and assist in maintaining the anvil 20 in a
closed state during staple formation and severing. Spacing between
the elongated channel 14 and anvil 20 may be further maintained by
the cutting head 182 by middle pins 187 on the cutting head 182
that slide along a portion of the elongated channel 14 while a
bottom foot 188 formed on the cutting head 182 opposingly slides
along the undersurface of the elongated channel 14 in a known
manner. The distally presented tissue-cutting surface 184, which is
between the upper guide fins 186 and middle pin 187, severs clamped
tissue while causing the staples within the staple cartridge 30 to
be formed into the tissue clamped within the end effector 12. The
proximal end of the knife bar 180 is provided with a proximal
socket 189 that is configured to receive a distal end portion 532
of the firing rod 530. As will be discussed in further detail
below, the firing rod 530 facilitates the application of firing and
retraction motions to the knife bar 180 by the actuation system
410. In various arrangements, the firing rod 530 extends through a
closure bushing 540 that is mounted within the handle assembly 400.
In at least one form, a pair of mounting studs 407 protrude from
the handle casings 402, 404 and extend through corresponding slots
in the closure carriage 420 to be received in a retaining slot in
the bushing 540. A closure spring 550 that is attached to a
retainer clip 552 is journaled on the closure bushing 540. The
closure spring 550 extends between the nozzle body 252 and an
internal wall 425 in the closure carriage 420. Thus, the closure
spring 550 serves to bias the closure carriage 420 in the proximal
direction "PD".
[0096] Various embodiments also include a releasable closure
locking assembly 560 that interfaces with the closure carriage 420
to selectively retain the closure carriage 420 in its distal-most
closed or clamped position. In at least one form, the closure
locking assembly 560 includes a locking button 562 that is
pivotally supported in the handle assembly 400. The locking button
562 has a latch arm 564 that is configured to abut a locking ledge
426 formed on the closure carriage 420 when the button 562 is in
the locked position. In addition, the latch arm 564 has a catch 566
formed thereon that is configured to releasably latch with a
locking latch 502 on the proximal end of the firing rack 500. A
locking spring 568 serves to bias the locking button 562 into the
locked position. See FIG. 16.
[0097] Operation of the surgical instrument 10 will now be
described with reference to FIGS. 12-33. FIGS. 12 and 13 illustrate
the jaws 13 and 15 of the end effector 12 in an open position. As
can be seen in FIG. 12, when the instrument 100 is in the open
position, the latch arm 564 is located on top of the locking ledge
426 formed on the closure carriage 420 such that the catch 566 of
the latch arm 564 is in retaining engagement with the locking latch
502 on the firing rack 500. Thus, when in this initial starting
position, the knife bar 180 cannot be inadvertently actuated. FIGS.
13-15 also depict the surgical instrument 10 in the initial
unactuated position. As can be seen in those Figures, the clutch
plate 510 is in its proximal-most unactuated position. In addition,
the closure carriage 420 is in its proximal-most starting or
unactuated position. When in that position, the clutch drive bevel
489 on the clutch shaft 482 is in contact with a portion of the
closure carriage 420, which prevents the clutch shaft 482 from
laterally moving into meshing engagement with the drive gear 490
under the bias of the clutch spring 520.
[0098] FIGS. 16-19 illustrate the surgical instrument 10 after a
first stroke has been applied to the trigger assembly 430. That is,
the trigger assembly 430 has been initially pivoted toward the
pistol grip 406. Such pivoting action serves to drive the closure
carriage 420 in the distal direction "DD" by virtue of the meshing
engagement between the closure gear segment 466 on the secondary
trigger 460 and the carriage rack 423 formed on the underside of
the closure carriage 420. Such distal movement of the closure
carriage 420 also axially advances the proximal outer shaft segment
300 and the distal closure tube segment 190 in the distal direction
"DD". As the distal closure tube segment 190 moves distally, the
distal end 196 thereof contacts the proximal end 21 of the anvil 20
to move the anvil 20 towards the surgical staple cartridge 30. If
the surgeon desires to simply grasp and manipulate tissue prior to
clamping it between the anvil 20 and the surgical staple cartridge
30, the trigger assembly 430 may be pivoted to open and close the
anvil 20 without fully pivoting the trigger assembly 430 to the
fully closed position depicted in FIG. 16.
[0099] Those of ordinary skill in the art will understand that, as
the trigger assembly 430 is pivoted toward the pistol grip 406, the
actuation bar 470 will necessarily also be driven distally by
virtue of the meshing engagement between the primary gear segment
446 on the primary trigger 440 and the first actuation rack 472 on
the actuation bar 470. The distal movement of the actuation bar 470
will also result in the an application of a rotary actuation motion
to the clutch shaft 482 by virtue of the meshing engagement between
the clutch teeth 484 on the clutch shaft 482 and the second
actuation rack 474 on the actuation bar 470. However, such rotary
motion is not applied to the drive gear 490 because the clutch arm
514 of the clutch plate 510, in contact with the clutch drive bevel
489 on the clutch shaft 482, prevents the axial movement of the
clutch shaft 482 into meshing engagement with the drive gear 490.
Thus, the clutch shaft 482 freely rotates relative to the drive
gear 490. Accordingly, the clutch assembly 480 automatically
prevents the activation of the firing rack 500 during the initial
actuation of the trigger assembly 430.
[0100] Once the trigger assembly 430 has been initially fully
compressed into the closed position (FIG. 16), the anvil 20 will be
retained in the locked or clamped position by the closure locking
assembly 560 which prevents the proximal movement of the closure
carriage 420. More specifically, as can be seen in FIG. 16, when
the trigger assembly 430 is initially pivoted to the closed
position, the latch arm 564 of the locking button 562 pivots off of
the locking ledge 426 formed on the closure carriage 420 and
thereby prevents the closure carriage 420 from moving in the
proximal direction "PD" under the bias the of closure spring 550.
Thus, the closure carriage 420 and the end effector 12 are retained
in the locked or clamped position when the surgeon releases the
trigger assembly 430. After the surgeon releases the trigger
assembly 430, the primary trigger 440 returns to its starting
position under the biasing force of the trigger spring 432. The
secondary trigger 460 is retained in its locked position by virtue
of the meshing engagement between the closure rack 466 on the
secondary trigger 460 and the carriage rack 423 formed on the
underside of the closure carriage 420. The actuation system 410 is
now ready to apply the second actuation motion to the end effector
12 to cut and staple the tissue clamped therein.
[0101] FIGS. 20-23 illustrate the surgical instrument 10 in its
"ready-to-fire" position. As can be seen in FIG. 20, when in the
ready-to-fire position, the catch 566 on the latch arm 564 is
disengaged from the locking latch 502 on the firing rack 500. As
can be seen in FIG. 21, when the closure carriage 420 has been
advanced to its distal-most, closed position, it no longer contacts
the clutch drive bevel 489 on the clutch shaft 482. When the
surgeon releases the trigger assembly 430, the spring 432 causes
the primary trigger 440 to return to its unactuated, starting
position. As the primary trigger 440 pivots to the starting
position, the clutch pin 449, by virtue of its sliding engagement
in slot 512 in the clutch plate 510, causes the clutch plate 510 to
move in the proximal direction "PD". As the clutch arm 514 moves
proximally, an arcuate relief 516 in the shaft arm 514 coincides
with the clutch drive bevel 489 to thereby permit the clutch spring
520 to laterally bias the clutch shaft 482 into meshing engagement
with the drive gear 490. See FIGS. 22 and 23. Once the clutch shaft
482 is in meshing engagement with the drive gear 490, further
actuation of the primary trigger 440 will cause the firing rack 500
to be driven distally.
[0102] FIGS. 24-27 illustrate the firing of the instrument 10. In
particular, to drive the knife bar 180 distally through the tissue
clamped in the end effector 12, the surgeon again pivots the
primary trigger 440 toward the pistol grip 406 of the handle
assembly 400. As the primary trigger 440 is pivoted, the firing
rack 500, the firing rod 530, and the knife bar 180 are driven in
the distal direction "DD". After the knife bar 180 has been driven
through the tissue clamped in the end effector 12, the surgeon then
releases the primary trigger 440 to thereby permit the primary
trigger 440 to pivot to its unactuated position under the bias of
the firing spring 432. As the primary trigger 440 pivots back to
the starting position, the firing rack 500, firing rod 530, and
knife bar 180 are drawn proximally back to their respective
starting positions. The end effector 12 remains in its clamped
position as shown in FIGS. 28-31. As the primary trigger 440 pivots
back to the starting position, the clutch pin 449 moves the clutch
plate 510 to again bring the relief 516 in the shaft arm 514 of the
clutch plate 510 into alignment with the clutch drive bevel 489 as
shown in FIGS. 29-31. The closure carriage 420 remains in the
locked position.
[0103] To unlock the closure carriage 420 and the secondary trigger
460, the surgeon depresses the locking button 562. As the locking
button 562 is depressed, the locking arm 564 is pivoted out of
abutting engagement with the locking ledge 426 on the closure
carriage 420 as shown in FIG. 32. Such action permits the closure
carriage 420 to be biased in the proximal direction "PD" by the
closure spring 550. As the closure carriage 420 moves in the
proximal direction "PD", the secondary trigger 460 is driven to the
starting position. As closure carriage 420 moves proximally, a
sloped surface 421 thereon contacts the clutch drive bevel 489 and
laterally biases the clutch drive shaft 482 out of meshing
engagement with the drive gear 490. When in the starting position
as shown in FIG. 33, the closure carriage 420 retains the clutch
drive shaft 482 out of meshing engagement with the drive gear 490.
As the closure carriage 420 moves proximally, the proximal outer
shaft segment 300, the flexible neck assembly 110, and the distal
closure tube segment 190 are drawn proximally. As the distal
closure tube segment 190 moves proximally, the distal tab 196
thereon contacts the proximal end wall of the slot 25 in the anvil
assembly 20 and causes the anvil assembly 20 to pivot to the open
position as shown.
[0104] Thus, as can be appreciated from the foregoing, at least one
surgical instrument embodiment of the present invention is manually
actuatable by sequential actuation of the trigger assembly. That
is, at least one form of the surgical instrument disclosed herein
employs an actuation system that is configured to apply at least
two actuation motions to an end effector that is coupled thereto
upon sequential actuations of the trigger assembly of the
instrument. One of the actuation motions comprises a first axial
closure motion that is applied to the closure carriage and proximal
outer shaft segment that ultimately results in the closure of the
end effector jaws. The second actuation motion comprises another
axial motion that is applied to the end effector upon an
application of a second actuation ("stroke") of the trigger
assembly. In at least one form, the second axial motion is applied
to a knife bar that is driven axially through the end effector to
cut tissue and fire the staples operably supported in the end
effector. While the various embodiments of the surgical instruments
disclosed herein have been described in connection with the use and
actuation of end effectors that are configured to cut and staple
tissue, those of ordinary skill in the art will appreciate that the
various surgical instruments disclosed herein and their equivalent
structures may be effectively employed in connection with other
surgical end effectors that may be actuatable by the application of
at least one axial actuation motion thereto.
[0105] FIGS. 34-48 depict another surgical instrument embodiment
610. The surgical instrument 610 is designed to manipulate and/or
actuate various forms and sizes of end effectors 612 that are
operably attached thereto. In the depicted embodiment, for example,
the end effector 612 comprises a surgical stapling device that has
openable and closable jaws 613 and 615. More specifically, the end
effector 612 includes an elongated channel 614 that forms a lower
jaw 613 of the end effector 612. The elongated channel 614 is
configured to support a compressible staple cartridge 630 that may
be of the type and construction disclosed in co-pending U.S. patent
application Ser. No. ______, entitled "Staple Cartridge Including
Collapsible Deck", Attorney Docket No. END7020USNP/110374 and U.S.
patent application Ser. No. ______, entitled "Staple Cartridge
Including Collapsible Deck Arrangement", Attorney Docket No.
END7019USNP/110375, and U.S. patent application Ser. No.
12/894,351, entitled "Surgical Cutting and Fastening Instruments
With Separate and Distinct Fastener Deployment and Tissue Cutting
Systems", the disclosures of which are each herein incorporated by
reference in their respective entireties. However, it is
conceivable that the surgical instrument 610 may be employed to
activate a variety of different surgical end effectors. For
example, the unique and novel features of various embodiments may
be successfully employed in connection with those end effectors
that are configured to apply radio frequency "RF" energy to tissue
clamped or otherwise engaged therein. Thus, the various embodiment
of the surgical instruments disclosed herein should not be limited
to use solely in connection with the types and forms of end
effector depicted in the appended Figures.
[0106] In various implementations, the end effector 612 is
configured to be operably coupled to an elongated shaft assembly
700 that protrudes from a handle assembly 900. The end effector 612
(when closed) and the elongated shaft assembly 700 may have similar
cross-sectional shapes and be sized to operably pass through a
trocar tube or working channel in another form of access
instrument. As used herein, the term "operably pass" means that the
end effector 612 and at least a portion of the elongated shaft
assembly 700 may be inserted through or passed through the channel
or tube opening and can be manipulated therein as needed to
complete the surgical procedure. In some embodiments, when in a
closed position, the jaws 613 and 615 of the end effector 612 may
provide the end effector with a roughly circular cross-sectional
shape that facilitates its passage through a circular
passage/opening. However, the end effectors of various embodiments
of the present invention, as well as the elongated shaft assembly
embodiments, could conceivably be provided with other
cross-sectional shapes that could otherwise pass through access
passages and openings that have non-circular cross-sectional
shapes. Thus, an overall size of a cross-section of a closed end
effector will be related to the size of the passage or opening
through which it is intended to pass. Thus, one end effector for
example, may be referred to as a "5 mm" end effector which means it
can operably pass through an opening that is at least approximately
5 mm in diameter.
[0107] In various embodiments, the elongated shaft assembly 700 may
have an outer diameter that is substantially the same as the outer
diameter of the end effector 612 when in a closed position. For
example, a 5 mm end effector may be coupled to an elongated shaft
assembly 100 that has 5 mm cross-sectional diameter. However, as
the present Detailed Description proceeds, it will become apparent
that various embodiments of the present may be effectively used in
connection with different sizes of end effectors. For example, a 10
mm end effector may be attached to an elongated shaft that has a 5
mm cross-sectional diameter. Conversely, for those applications
wherein a 10 mm or larger access opening or passage is provided,
the elongated shaft assembly 700 may have a 10 mm (or larger)
cross-sectional diameter, but may also be able to actuate a 5 mm or
10 mm end effector. Accordingly, the elongated shaft assembly 700
may have an outer diameter that is the same as or is different from
the outer diameter of a closed end effector 612 attached
thereto.
[0108] As can be seen in FIGS. 34-37, in at least one embodiment,
the elongated shaft assembly 700 includes a flexible articulation
joint segment 720. In various embodiments, the flexible
articulation joint segment 720 comprises a fenestrated shaft that
is fabricated in two pieces for assembly purposes. That is, the
flexible articulation joint segment 720 comprises a fenestrated
upper joint segment 730 and a fenestrated lower joint segment 740
that are interconnected by snap features, adhesive, fasteners, etc.
The flexible articulation joint segment 720 may be composed of, for
example, a rigid thermoplastic polyurethane sold commercially as
ISOPLAST grade 2510 by the Dow Chemical Company. As can be seen in
FIG. 37, in at least one embodiment, the upper joint segment 730
has a flexible upper neck segment 731 that comprises first and
second upper flexible neck portions, 732 and 733. These upper neck
portions 732, 733 are separated by a central longitudinal upper rib
734. Likewise, the lower joint segment 740 has a flexible lower
neck segment 741 that comprises first and second lower flexible
neck portions 742, 743. These lower neck portions 742, 743 are
separated by a central longitudinal lower rib 744. The upper neck
portions 732, 734 each have a plurality of upper neck ribs 735. The
lower neck portions 742 and 743 each have a plurality of lower neck
ribs 745. The upper and lower neck ribs 735, 745 are configured
essentially as semi-circular disks which together generally form a
cylindrical configuration when the upper joint segment 730 is
joined with the lower joint segment 740.
[0109] In various embodiments, the upper joint segment 730 further
has an upper tubular portion 736 and the lower joint segment 740
has a lower tubular portion 746. When joined together, the upper
and lower tubular portions 736, 746 serve to receive therein two
distally protruding attachment arms 616 that protrude proximally
from the elongated channel 614. The attachment arms 616 have
attachment tabs 618 thereon that engage the upper tubular portion
736 to affix the elongated channel 614 to the elongated shaft
assembly 700. Other methods of attaching the elongated channel 614
to the elongated shaft assembly 700 may also be employed.
[0110] In at least one embodiment, the elongated shaft assembly 700
includes a substantially rigid proximal outer shaft segment 760
that has a distal end 762 is coupled to the flexible articulation
joint 720 by, for example, pins or a tongue and groove slot
arrangement. The proximal outer shaft segment 760 further has a
proximal end 764 that is non-rotatably coupled to a nozzle assembly
770 that is rotatably supported on the handle assembly 900. In
various embodiments, the handle assembly 900 comprises a
pistol-shaped housing 902 that may be fabricated in two or more
pieces for assembly purposes. For example, the handle assembly 900
as shown comprises a right hand case member 904 and a left hand
case member 906 (FIG. 34) that are molded or otherwise fabricated
from a polymer or plastic material and are designed to mate
together. Such case members 904 and 906 may be attached together by
snap features, pegs and sockets molded or otherwise formed therein
and/or by adhesive, screws, etc. and form a handle assembly with a
pistol grip portion 908.
[0111] In various embodiments, the nozzle assembly 770 comprises a
nozzle member 772 that is non-rotatably attached to a nozzle
bushing 774 by, for example, welding, gluing, press fit, etc. In at
least one form, the nozzle bushing 774 has a pair of flanges that
are rotatably supported within corresponding cavities provided in
the housing 900. Such arrangement permits the nozzle member 772 to
be selectively rotated relative to the handle housing 902. The
proximal end 764 of the outer shaft segment 760 extends through the
nozzle member 772 and nozzle bushing 774 and is attached thereto
by, for example, welding, gluing, press fit, etc. Such arrangement
permits the surgeon to rotate the end effector 612 about the
longitudinal axis L-L by rotating the nozzle member 772 relative to
the handle housing 902.
[0112] In addition, the upper and lower portions 730, 740 of the
flexible articulation joint segment 720, when joined together, form
a passage 750 for receiving a knife bar assembly 780. In various
forms, the knife bar assembly 780 includes a distal knife bar
portion 782 that may be of laminated construction to enable it to
flex through the flexible articulation joint segment 720. In the
depicted embodiment, the distal knife bar portion 782 terminates in
a cutting head 784 that has a tissue-cutting surface 786
thereon.
[0113] Various embodiments of the end effector 612 include an anvil
620 that has a pair of trunnions 622 that are configured to be
movably received in cavities 619 in the elongated channel 614. In
the depicted embodiment, the cutting head 784 is configured to
operably retain the anvil 620 in movable engagement with the
elongated channel 614. For example, in at least one embodiment, the
cutting head 784 includes upper guide fins 787 that are configured
to extend into a pocket 623 formed in the anvil 620 and serve to
retain the anvil 620 on the elongated channel 614. The anvil 620 is
pivoted between an open position (FIG. 38) and closed positions
(FIGS. 39-41) by virtue of the axial movement of the knife bar
assembly 780 in the distal direction "DD". The cutting head 784
further has lower guide fins 787 formed thereon such that, as the
cutting head 784 is driven distally, the anvil 620 is pressed into
the crushable implantable cartridge 630 that is operably supported
in the elongated channel 614. As the anvil 620 is pressed into the
cartridge 630, the staples that are supported within the cartridge
are pressed and formed into the tissue clamped in the end effector
612 on both sides of the tissue cutline. After the tissue has been
cut and the staples formed, the cutting head 784 is withdrawn in
the proximal direction "PD" to the starting position wherein the
cutting head 784 interacts with the anvil 620 to move the anvil 620
to the open position as shown in FIG. 38.
[0114] As will be discussed in further detail below, in at least
one embodiment, the axial advancement and withdrawal of the knife
bar assembly 780 is controlled by the manual activation of a firing
trigger that is operably supported on the handle assembly 900. As
can be seen in FIG. 36, a connector member 790 is coupled to a
proximal end 787 of the distal knife bar portion 782. In at least
one embodiment, for example, the connector member 790 is pinned to
the proximal end 787 of the distal knife bar portion 782 and has a
proximally protruding attachment feature 792 that is configured to
be coupled to a distal end 802 of a hollow knife tube 800. The
hollow knife tube 800 extends through the outer shaft segment 760
and into the handle housing 902 and is attached to a carriage
assembly 810. In various embodiments, for example, the carriage
assembly 810 comprises a flanged carriage bushing 812 that is press
fit onto a portion of the knife tube 800. The carriage assembly 810
further comprises a firing carriage 814 that has a saddle formed
therein configured to extend over the carriage bushing 812 between
the bushing flanges 813. In at least one form, the firing carriage
814 also has a pair of laterally extending portions 816 that each
have a support tab 818 formed thereon. The support tabs 818 are
configured to be slidably received in a corresponding slide passage
(not shown) formed in the handle housing 902. Such arrangement
permits the firing carriage 814 to move axially within the handle
assembly 900 and thereby apply axial actuation motions to the knife
tube 800 while permitting the knife tube 800 to rotate about the
longitudinal axis L-L relative to the firing carriage 824 as the
nozzle assembly 770 is rotated.
[0115] In at least one embodiment, actuation motions may be
manually applied to the firing carriage 814 by a firing trigger
assembly 820 that is pivotally supported on the handle assembly
900. The firing trigger assembly 820 includes a firing trigger 822
that has an attachment plate 824 that is configured to operably
interface with a pair of actuation plates 826. As can be seen in
FIG. 36, the attachment plate 824 is located between the actuation
plates 826 and is pivotally pinned thereto by a first pivot pin 828
that extends through slots 830 in the actuation plates 826 and a
hole 825 in the attachment plate 824. A second pivot pin 832 is
received within or is supported by mounting lugs in the handle
cases 904, 906 and extends between holes 834 in the actuation
plates 826. Each of the actuation plates 826 have a lug 836 that
extends into a corresponding pocket or opening 815 in the firing
carriage 814. Such arrangement facilitates the application of axial
actuation motions to the knife tube 800 by pivoting the firing
trigger 822 relative to the handle housing 902. As the firing
trigger 822 is pivoted towards the pistol grip portion 908 of the
handle housing 902, the firing carriage 814 is driven in the distal
direction "DD". As the firing trigger 822 is pivoted away from the
pistol grip portion 908 of the handle housing 902, the firing
carriage 814 draws the knife tube 800 in the proximal direction
"PD".
[0116] Various embodiments of the surgical instrument 610 further
include a locking system 840 that includes a locking trigger 842
that is pivotally coupled to the handle housing 902. The locking
trigger 842 includes a locking bar portion 844 that is configured
to operably engage a locking member 846 that is pivotally attached
to the attachment plate 824 of the firing trigger 822 by pin 849.
When the locking trigger 842 is in the unactuated position, the
locking bar 842 prevents the locking member 846 from pivoting
beyond the point illustrated in FIG. 40.
[0117] Actuation of the end effector 612 will now be explained with
reference to FIGS. 37-42. FIG. 37 illustrates the surgical
instrument 610 in the unfired position with the end effector 612 in
an open position. While grasping the pistol grip portion 908 of the
handle assembly 900, the surgeon may apply a closing motion to the
anvil 620 of the end effector 612 by applying an actuation force
"F" to the firing trigger 822 as shown in FIG. 39. Such action
results in the application of an actuation motion to the firing
carriage 814 by the actuation plates 826 which ultimately results
in the axial displacement of the knife tube 800 in the distal
direction "DD". As the knife tube 800 is advanced in the distal
direction "DD", the knife bar assembly 780 is likewise driven in
the distal direction "DD". As the knife bar assembly 780 and, more
particularly the cutting head 784, is driven in the distal
direction "DD", the cutting head 784 advances out of the pocket 623
in the anvil 620 and contacts a sloped surface feature 625 on the
anvil 620 to start to apply a closing motion to the anvil 620.
Further application of the actuation force "F" to the firing
trigger 822 results in further axial displacement of the knife tube
800 and the cutting head 784 as shown in FIG. 40. Such action
further moves the anvil 620 towards the elongated channel 614. As
the firing trigger 822 is pivoted towards the pistol grip portion
908 of the handle assembly 900, the locking member 848 also pivots
in the counterclockwise "CCW" direction about the pin 849. At this
point, the cutting head 784 is prevented from moving any further in
the distal direction "DD" by virtue of the locking system 840. More
particularly, as can be seen in FIG. 40, the distal end of the
locking member 848 is prevented from pivoting any further in the
counterclockwise "CCW" direction about pin 849 by the locking bar
portion 844 of the locking trigger 842. Thus, the surgeon may move
the anvil 620 to capture and manipulate tissue in the end effector
612 without risk of actually "firing" the end effector 612 (i.e.,
or cutting the tissue and forming the staples).
[0118] Once the surgeon desires to cut tissue and form staples, a
second actuation force "F'" is applied to the locking trigger 842
as shown in FIG. 41. As can be seen in that Figure, when the
locking trigger 842 is depressed, the locking bar portion 844
pivots to a forward position which thereby permits the locking
member 848 to continue to pivot in the counterclockwise direction
as the surgeon continues to apply the actuation force "F" to the
trigger 822. Such actuation of the firing trigger 822 results in
the axial displacement of the cutting head 784 through the anvil
620. As the cutting head 784 moves distally through the end
effector 612, the cutting surface 786 cuts tissue and the anvil 620
is pressed into the cartridge 630 by the fins 787, 788. As the
anvil 620 is compressed into the cartridge 630, the staples
supported therein are formed into the tissue on each side of the
tissue cut line.
[0119] After completing the cutting and stapling process, the
firing trigger 822 may be released. A return spring (not shown)
attached to the firing trigger 822 returns the firing trigger 822
to the unactuated position. Alternative, the user can use the hook
feature of the trigger to "pull" open the trigger if no spring is
used. As the firing trigger 822 moves in the clockwise "CW"
direction, the firing carriage 814 is moved in the proximal
direction "PD" which also moves the knife bar assembly 780 in the
proximal direction "PD". As the cutting head 784 re-enters the
pocket 623 in the anvil 620, the anvil 620 is once again pivoted to
the open position.
[0120] Various forms of the present invention further employ a
unique and novel articulation system generally designated as 1000
for articulating the end effector 612 about the flexible
articulation joint 720. In at least one embodiment, the
articulation system 1000 comprises first and second articulation
band assemblies 1010 and 1020. It will be understood, however, in
alternative embodiments, only one articulation band assembly is
employed. In at least one embodiment, the first articulation band
assembly 1010 comprises a flexible first distal segment 1012 that
is fabricated from, for example, spring steel, 420 stainless steel,
titanium, 400 or 300 grade stainless steel and has a first hook
1014 formed in its distal end. The first hook 1014 is configured to
hookingly engage a first hook-receiving feature 748 formed in the
lower tube portion 746 of the flexible articulation joint 720 on a
first side of the longitudinal axis L-L. The first articulation
band assembly 1010 further includes a first structural band portion
1016 that is attached to (e.g., pinned) to the first distal segment
1012. The first structural band portion 1016 may be fabricated
from, for example, spring steel, 420 stainless steel, titanium.
Likewise, the second articulation band assembly 1020 comprises a
flexible second distal segment 1022 that is fabricated from, for
example, spring steel, 420 stainless steel, titanium and has a
second hook 1024 formed in its distal end. See FIG. 36. The second
hook 1024 is configured to hookingly engage a second hook-receiving
feature 749 formed in the lower tube portion 746 of the flexible
articulation joint 720 on a second side of the longitudinal axis
L-L. The second articulation band assembly further includes a
second structural band portion 1026 that is attached to (e.g.,
pinned) to the second distal segment 1022. The second structural
band portion 1026 may be fabricated from, for example, 400 or 300
grade stainless steel.
[0121] Various embodiments of the articulation system 1000 include
a novel articulation transmission 1030 that is supported within the
handle assembly 900 for applying articulation motions to the first
and second articulation band assemblies 1010, 1020. In various
forms, the articulation transmission 1030 includes an actuator
wheel 1040 that is rotatably supported on the handle assembly 900
for selective rotation about an actuation axis. In at least one
embodiment, the actuation axis coincides with or is substantially
coaxial with the longitudinal axis L-L. Thus the actuation axis
does not transversely intersect the longitudinal axis. In other
embodiments, the actuation axis may be substantially parallel to
the longitudinal axis. To facilitate ease of assembly and
manufacturing, the actuator wheel 1040 is fabricated in two pieces
1040A, 1040B that may be attached together by screws, snap
features, adhesive etc. When assembled, the actuator wheel 1040 has
a first set of actuator threads 1042 which are configured in a
first direction for threaded engagement with a first thread nut
assembly 1060. In addition, the actuator wheel also has a second
set of actuator threads 1044 which are configured in a second
direction that differs from the first direction. For example, the
first threads 1042 may comprise "right hand" threads and the second
threads 1044 may comprise "left hand" threads or visa versa. The
second threads 1044 are adapted to threadably engage a second
threaded nut assembly 1070.
[0122] In various embodiments, the first threaded nut assembly 1060
comprises a first disc 1062 that has first threads 1064 formed
thereon. The first disc 1062 is supported on the knife tube 800 by
a first bearing bushing 1066. The first bearing bushing 1066
facilitates movement of the first disc 1062 relative to the knife
tube 800. Similarly, the second threaded nut assembly 1070
comprises a second disc 1072 that has second threads 1074 formed
thereon. The second disc 1072 is supported on the knife tube 800 by
a second bearing bushing 1076 that facilitates movement of the
second disc 1072 relative to the knife tube 800. The first and
second discs 1062, 1072 are also movably supported on upper and
lower nut rails 1050, 1052 that are mounted to standoff posts 905
molded into the handle cases 904, 906. See FIG. 36. The upper and
lower nut rails 1050, 1052 serve to prevent the first and second
discs 1062, 1072 from rotating relative to the handle housing 902
and therefore, as the actuator wheel 1040 is rotated relative to
the handle housing 902, the first and second bearing bushings 1066,
1076 move axially on the knife tube 800 in different
directions.
[0123] The first and second band assemblies 1010, 1020 are
controlled by rotating the actuator wheel 1040 relative to the
handle housing 902. To facilitate the application of such control
motions, the first structural band portion 1016 has a first catch
member configured to retainingly engage the first bearing bushing
1066 and the second structural band portion 1026 has a second catch
member configured to retainingly engage the second bearing bushing
1076. In addition, the articulation system 1000 in at least one
form includes an elongated support beam 1080 that extends
longitudinally within the knife tube 800 to provide lateral support
to the first and second structural band portions 1016, 1026 within
the knife tube 800. The support beam 1080 may be fabricated from,
for example, 400 or 300 grade stainless steel and is configured to
facilitate axial movement of the first and second structural band
portions 1016, 1026 while providing lateral support thereto.
[0124] Operation of the articulation system 1000 may be understood
from reference to FIGS. 43-48. FIGS. 43 and 44 illustrate the
surgical instrument 610 in an unarticulated position. That is, when
in an unarticulated position, the end effector 612 is substantially
axially aligned on the longitudinal axis L-L as shown in FIG. 43.
When in that "neutral" position, the first and second discs 1062,
1072 are spaced away from each other in the position shown in FIG.
44. To provide the surgeon with an indication when the articulation
system 1000 has been parked in the neutral position, a detent
assembly 1090 is mounted within the handle housing 902. The detent
assembly 1090 into the housing 902 and is adapted to engage a
recess (not shown) in the hub portion 1041 of the actuator wheel
1040. See FIG. 36. The detent assembly 902 is configured to engage
the recess when the actuator wheel 1040 is in the neutral position.
When the detent 1090 engages the recess, the surgeon may receive a
tactile and/or audible indication.
[0125] FIGS. 45 and 46 illustrate the articulation of the end
effector 612 relative to the longitudinal axis L-L in a first
articulation direction "FAD". The articulation system 1000
articulates the end effector 612 about the flexible articulation
joint 720 in the following manner. First, the surgeon rotates the
articulation actuator wheel 1040 in a first direction which causes
the first and second discs 1062, 1072 to move toward each other to
the position shown in FIG. 46. As the first disc 1062 moves in the
proximal direction "PD", the first articulation band assembly 1010
is pulled in the proximal direction "PD" by virtue of the first
catch feature 1017 which is coupled to the first bearing bushing
1066. Likewise, as the second disc 1072 moves in the distal
direction "DD", the second articulation band assembly 1020 is
pushed in the distal direction "DD" by virtue of the second catch
feature 1027 which is coupled to the second bearing bushing 1076.
Such action of the first and second articulation band assemblies
1010, 1020 causes the end effector 612 to articulate in the first
articulation direction "FAD" by virtue of the first and second
articulation bands 1010, 1020 interconnection with the lower tube
portion 746 of the flexible articulation joint 720 which is coupled
to the end effector 612.
[0126] FIGS. 47 and 48 illustrate the articulation of the end
effector 612 relative to the longitudinal axis L-L in a second
articulation direction "SAD". The articulation system 1000
articulates the end effector 612 about the flexible articulation
joint 720 in the following manner. First, the surgeon rotates the
articulation actuator wheel 1040 in a second direction which causes
the first and second discs 1062, 1072 to move away from each other
to the position shown in FIG. 48. As the first disc 1062 moves in
the distal direction "DD", the first articulation band assembly
1010 is pushed in the distal direction "PD" by virtue of the first
catch feature 1017 which is coupled to the first bearing bushing
1066. Likewise, as the second disc 1072 moves in the proximal
direction "PD", the second articulation band assembly 1020 is
pulled in the proximal direction "PD" by virtue of the second catch
feature 1027 which is coupled to the second bearing bushing 1076.
Such action of the first and second articulation band assemblies
1010, 1020 causes the end effector 612 to articulate in the second
articulation direction "SAD" by virtue of the first and second
articulation bands 1010, 1020 interconnection with the lower tube
portion 746 of the flexible articulation joint 720 which is coupled
to the end effector 612.
[0127] The devices disclosed herein can be designed to be disposed
of after a single use, or they can be designed to be used multiple
times. In either case, however, the device can be reconditioned for
reuse after at least one use. Reconditioning can include any
combination of the steps of disassembly of the device, followed by
cleaning or replacement of particular pieces, and subsequent
reassembly. In particular, the device can be disassembled, and any
number of the particular pieces or parts of the device can be
selectively replaced or removed in any combination. Upon cleaning
and/or replacement of particular parts, the device can be
reassembled for subsequent use either at a reconditioning facility,
or by a surgical team immediately prior to a surgical procedure.
Those skilled in the art will appreciate that reconditioning of a
device can utilize a variety of techniques for disassembly,
cleaning/replacement, and reassembly. Use of such techniques, and
the resulting reconditioned device, are all within the scope of the
present application.
[0128] Preferably, the invention described herein will be processed
before surgery. First, a new or used instrument is obtained and if
necessary cleaned. The instrument can then be sterilized. In one
sterilization technique, the instrument is placed in a closed and
sealed container, such as a plastic or TYVEK bag. The container and
instrument are then placed in a field of radiation that can
penetrate the container, such as gamma radiation, x-rays, or
high-energy electrons. The radiation kills bacteria on the
instrument and in the container. The sterilized instrument can then
be stored in the sterile container. The sealed container keeps the
instrument sterile until it is opened in the medical facility.
[0129] Any patent, publication, or other disclosure material, in
whole or in part, that is said to be incorporated by reference
herein is incorporated herein only to the extent that the
incorporated materials does not conflict with existing definitions,
statements, or other disclosure material set forth in this
disclosure. As such, and to the extent necessary, the disclosure as
explicitly set forth herein supersedes any conflicting material
incorporated herein by reference. Any material, or portion thereof,
that is said to be incorporated by reference herein, but which
conflicts with existing definitions, statements, or other
disclosure material set forth herein will only be incorporated to
the extent that no conflict arises between that incorporated
material and the existing disclosure material.
[0130] While this invention has been described as having exemplary
designs, the present invention may be further modified within the
spirit and scope of the disclosure. This application is therefore
intended to cover any variations, uses, or adaptations of the
invention using its general principles. Further, this application
is intended to cover such departures from the present disclosure as
come within known or customary practice in the art to which this
invention pertains.
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