Surgery – Instruments
Reexamination Certificate
2001-12-11
2003-12-23
Peffley, Michael (Department: 3739)
Surgery
Instruments
C606S205000, C606S208000
Reexamination Certificate
active
06666854
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of Invention
The present invention relates to an instrument for endoscopic surgery with principal applications to laparoscopy (abdominal endoscopic surgery) and thoracoscopy (endoscopic surgery of the thorax).
2. Description of Related Art
This endoscopic surgical instrument belongs to the species of those having a handle extended by an elongated tubular part, itself connected by a multidirectional joint to a terminal or distal part able to carry a tool, control means being provided in the handle area to control the angle of the terminal part by means of a mechanical wire or cable transmission passing inside the tubular part, also traversed by a central tool control cable.
An endoscopic surgical instrument of this type is known from European Patent Application EP 0 646 356 A2. Because of its articulated distal end, such an instrument offers the surgeon access to a larger part of the surgical field, enabling him to choose the direction of approach and making the procedure more effective. This, the surgeon is freed of the constraints linked to endoscopic surgery, particularly passage through a fixed point (such as the point of entry into the abdomen).
However, the embodiment described and illustrated in the European patent application referred to above remains imperfect, and has in particular the following drawbacks:
In the embodiment subject of European Patent Application EP 0 646 356 A2, it is not possible to rotate the distal part of the instrument about its own lengthwise axis from the control element located on the handle. Moreover, this control element is located in the back part of the handle, which is a non-ergonomic position that could lead to inaccurate control.
When the above document is reduced to practice, at least in certain embodiments, the transmission wires have to be crossed, reversing the direction of movement of the distal end of the instrument relative to the control. Moreover, the crossing of the wires complicates their path and brings about friction. This crossing also reduces the free space available for controlling the tool on the instrument, for example the forceps opening and closure control.
Since the transmission wires of the instrument according to document EP 0 646 356 A2 are anchored to the ball joint of the distal part, the maximum authorized displacement remains relatively limited.
Moreover, in the instrument according to the aforesaid document, there is no provision for locking the orientation mechanism in any position that is to be temporarily maintained; thus, as soon as the control is released, the mechanism returns to the starting position (central position), urged by springs.
Finally, the instrument described in document EP 0 646 356 A2 is not impermeable, except for an O-ring located on the ball joint, and is difficult to clean.
SUMMARY OF THE INVENTION
The goal of the present invention is to eliminate all these drawbacks by providing an endoscopic surgical instrument that is improved both in its control, rendered particularly ergonomic, and in its utilization options, while ensuring impermeability.
For this purpose, the invention relates essentially to an endoscopic surgical instrument of the type referred to at the outset wherein:
the control means, located in the front part of the handle, comprise a spherical crown having a center and an axis, the crown being orientable in all directions inside a cone relative to its center and being rotatable about its axis,
the spherical crown is linked at an angle to a part controlling wires or cables, the proximal ends of the transmission wires or cables being attached to said control part,
means, are provided to transmit the rotation of the spherical crown about its axis to an internal element mounted to rotate about the axis of the elongated tubular part, rotation of this element being transmitted, through the aforesaid joint, to the terminal part in order to orient this terminal part around its own lengthwise axis, and
means, are provided for non-permanent locking of the aforesaid joint at anyangle.
Preferably, the spherical crown is connected to the internal element mounted to rotate about the axis of the elongated tubular part by means of a gimbal mechanism.
Thus, the invention provides an endoscopic surgical instrument, characterized mainly by a single control element whose orientation enables the distal part of the instrument to be articulated at any angle, and whose rotation (about its own axis) enables the orientation of this distal part about its lengthwise axis to be controlled. The position of this single control element, in front of the handle, is ergonomic and reflects the simple rotation controls existing in the rigid, straight-line instruments available on the market and habitually used by surgeons.
In one embodiment of the invention, the output element of the gimbal mechanism is coupled to the central tool-controlling cable by means of a gear train able to transmit the rotary movement from the outside of the elongated tubular part to the inside thereof, the gear train comprising a gear linked rotationally to the output element of the gimbal mechanism, another gear rotationally linked to a central rod linked to the tool-controlling cable, and intermediate pinions, engaging the aforesaid two gears.
According to another embodiment of the invention, the output element of the gimbal mechanism is coupled to the central tool-controlling cable by magnetic means, in particular permanent magnets, with interposition of a fixed nonmagnetic impermeable wall.
According to another embodiment of the invention, the output element of the gimbal mechanism is coupled directly to an internal rotating tubular element surrounding the tool-controlling cable and forming a rotating assembly with the latter.
According to a simple arrangement, the control spherical crown is itself the operating element activatable by the user.
However, in a preferred embodiment the spherical crown is surrounded concentrically with an external operating ring to which it is coupled angle- and rotation-wise by magnetic means, in particular permanent magnets, with interposition of a fixed nonmagnetic impermeable wall. This design of the control, with an external element manipulated by the surgeon, coupled to an internal control crown, provides a sealed design, as the magnetic coupling produced through the fixed impermeable wall allows identical positioning and movement of the spherical control crown and the operating ring without mechanical complications.
Since such an endoscopic surgical instrument is normally provided with a separate control to activate the tool carried by the instrument, particularly a control for opening and closing a forceps by a small-amplitude translational movement, additional sealing means are also provided in the form of flexible sleeves located in the proximal and distal parts. Since an internal sealing sleeve located at the distal part is subject to torsion when this distal part rotates about its lengthwise axis, this torsion has to be limited in order not to tear the sleeve. For this purpose, the instrument also advantageously has mechanical means for limiting the rotation of the distal part. In one particular embodiment, these means comprise a part mounted to rotate freely in the handle, said part being entrained rotationally by a first finger linked rotationally with the internal element receiving the rotational movement of the spherical crown, the aforesaid part itself having a second finger that abuts a fixed part. Such a mechanism allows rotation around slightly less than two complete turns.
According to another aspect of the invention, the multidirectional joint between the elongated tubular part and the terminal or distal part of this instrument comprises a free intermediate ball joint able to describe an orientation movement with respect to a female ball joint integral with the front end of the elongated tubular part and also with respect to another female ball joint integral with the back end of the terminal part of the instrument, all these ball joints
La Precision
Oliff & Berridg,e PLC
Peffley Michael
LandOfFree
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