Device for use in surgery

Surgery – Instruments – Forceps

Reexamination Certificate

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Reexamination Certificate

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06582451

ABSTRACT:

FIELD OF THE INVENTION
The present invention relates generally to a surgical instrument for manipulating, grasping, cutting, cauterising, clipping, stapling, spreading, retracting or clamping tissues in the body of a patient or animal, or as a platform for diagnostic and therapeutic modalities and for applications to achieve cutting, haemostasis, sealing and joining of tissues. More specifically, the present invention relates to such a surgical instrument when adapted for use in the performance of minimally invasive or open procedures.
BACKGROUND OF THE INVENTION
It is well known to use surgical instruments with a jaw structure for manipulating, grasping, cutting, cauterising, clipping, stapling, spreading, retracting and/or clamping tissues in the body of a patient or animal during surgical procedures. Such instruments are also used in procedures involving minimally invasive intervention, such as arthroscopy, endoscopy, endoscopic spinal surgery, endoscopic neurosurgery, laparoscopy and thoracoscopy, among others.
Generally, the jaw members of such surgical instruments are brought relatively towards and away from each other through articulation of the respective proximal ends of the jaw members about a single pivot point or hinge. However, there are also instances where the jaw structure has been manufactured to incorporate more than one pivot point. Nevertheless, in these devices, the jaw opens in such a way that the respective distal ends of the jaw members move relatively apart while the respective proximal ends articulate about the pivot point. This scissor-like action, while widely utilised in surgical instruments, poses a number of problems which require further discussion.
On opening of the jaw, the distance between the distal ends of the jaw members exceeds the distance between the proximal ends. When an instrument having such a jaw is then used to grip a section of body tissue, the gripping pressure made on the tissue adjacent the proximal end exceeds that made by the jaw members adjacent their distal ends. In circumstances where it is critical that the section of tissue between the distal ends of the jaw members be gripped firmly, the risk of unintentional trauma to the tissue positioned adjacent the respective proximal ends of the instrument's jaw members is very high. This is particularly the case in endoscopic procedures where visibility and accessibility is limited. Further, the pivotal action can lead to tissue positioned between the jaw members being squeezed out of the jaw away from the pivot point.
One alternative jaw arrangement that is adapted to overcome the problem of scissor-like jaw structures is described in U.S. Pat. No. 5,749.893 to Vidal et al. This patent describes a surgical instrument in which the jaw members are capable of moving in a substantially parallel relation between a fully open position and an approximated position where the jaws are closed together. In one embodiment, the jaws of this structure are pivotally mounted such that its lower jaw may pivot with respect to the upper jaw. While a substantially parallel relation between the jaw members is obtained using this structure, it is not capable of maintaining a parallel relation through the entire range of motion of the jaw members.
The present invention provides a jaw structure that addresses the problems of scissor-like instruments.
SUMMARY OF THE INVENTION
In a first aspect, the present invention is a device for manipulating tissues in the body of a patient or animal, the device including:
support means:
a reciprocating member which moves relative to the support means;
an articulated jaw structure having:
a first and at least a second jaw member, each jaw member having a proximal end and a constraining surface adjacent its proximal end: and
an articulating means for articulating the jaw members in response to reciprocation of the reciprocating member, the articulating means including:
first and second connecting members, and at least first and second articulation members, wherein the first and second connecting members are each connected by a first pivotal connection to the reciprocating member and extend to respective second and third pivotal connections, and the first and second articulation members are connected together intermediate their respective ends by a fourth pivotal connection mounted to the support means, the first articulation member extending from said second pivotal connection to a fifth pivotal connection with the second jaw member distal its proximal end, and the second articulation member extending from said third pivotal connection to a sixth pivotal connection with the first jaw member distal its proximal end, the second pivotal connection being adapted to engage the constraining surface of the first jaw member and the third pivotal connection being adapted to engage the constraining surface of the second jaw member, such that on relative movement of the reciprocating member towards or away from the fourth pivotal connection, the second and third pivotal connections are caused to move relatively away from or towards one another, so moving the entire jaw members relatively away from or towards one another.
The configuration of the articulating means according to the above aspect enables relative movement of the reciprocating member towards or away from the fourth pivotal connection. As a result of such movement, the second and third pivotal connections are caused to move relatively away from or towards one another, so changing the configuration of the articulating means in a concertina fashion from a first to at least a second orientation. When in the first orientation, corresponding points on each of the jaw members are separated by a first distance; and similarly, when in the second orientation, corresponding points on each of the jaw members are separated by a second different distance. Two particular points on the respective jaw members are taken to be corresponding points as defined herein if, throughout the entire range of movement of the two jaw members, those two particular points maintain a constant positional relationship with one another. That is, those two particular points will always come back to the same relational positions with respect to one another, once the jaw members are moved back into the position which they were in when those two particular points were originally identified.
In the above aspect, reciprocation of the reciprocating member can result in movement of the jaw members in parallel relation to one another. In a preferred embodiment of the invention, both jaw members will move equal distances away from and towards each other. In an alternative embodiment, however, one jaw member may remain stationary while the other jaw member moves relative to it. In such an embodiment, the jaw member which remains stationary may be connected to, or be an integral part of, the support means.
In a still further embodiment, the surfaces of the two jaw members which face one another can be parallel. Alternatively, the faces can maintain an angular relationship with respect to one another, irrespective of the particular moving relationship between the two jaw members. These latter embodiments may, in fact, relate to the specific shape chosen for the jaw members, and it is noteworthy that all possible varieties of shape chosen for the individual jaw members fall within the scope of this invention.
The present invention can utilise a mechanism to achieve movement of the jaw members relatively toward and relatively away from one another, but wherein such movement is not restricted to being parallel. In such an embodiment, for example, an additional constraining surface may be incorporated into each of the articulation members. Accordingly, the pivotal connection between said articulation members can be adapted to engage both of their respective constraining surfaces simultaneously. While reciprocation of the reciprocating member will cause relative movement between the jaw members, the angular relationship of the latter will depend on where the piv

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