Surgery – Instruments – Forceps
Reexamination Certificate
2001-10-09
2003-01-14
Truong, Kevin T. (Department: 3731)
Surgery
Instruments
Forceps
C606S208000
Reexamination Certificate
active
06506208
ABSTRACT:
FIELD OF THE INVENTION
This invention relates to a surgical instrument and, in one example, a combined laparoscopic scissors and forceps device.
BACKGROUND OF THE INVENTION
Laparoscopic surgery is used to provide a wide variety of surgical procedures on a patient's abdomen. The application of laparoscopic methods continues to grow as techniques are refined and the associated surgical instruments are improved. Patients benefit from laparoscopic procedures because the methods employed minimize the amount of trauma associated with a given procedure. Hence, patient survival is enhanced and recovery times are decreased.
Prior art laparoscopic surgical instruments typically include a handle, a 33 centimeter length, 5 millimeter diameter shaft which can be inserted through a cannula placed in a patient's abdominal wall, and scissors or tissue grasping jaws (e.g., forceps) extending from the end of the shaft.
In some cases, laparoscopic graspers, and/or scissors and some other types of instruments have the ability to apply RF energy in order to locally vaporize tissue and thereby cut through it or to coagulate blood vessels. There are two common ways in which the RF energy is applied. In either method, current travels between two electrodes. In monopolar instruments, the surgical instrument serves as one electrode and the second electrode is a large surface area electrode placed on the patient. In bipolar instruments, both electrodes are disposed on the surgical instrument in close proximity to one another.
Many conventional laparoscopic surgical instruments tend to be clumsier than those used in conventional surgery. As explained above, in laparoscopic surgery, the surgical instruments are inserted through a cannula placed in the patient's abdominal wall. To keep patient trauma to a minimum, only a limited number of cannula are employed for a given procedure. Often, using existing surgical instruments, the instruments must be repeatedly removed from the cannula and replaced with different instruments and removed and replaced again. This process of repeated instrument exchanges greatly increases the time it takes to perform a given medical procedure.
Two commonly used laparoscopic instruments are scissors and tissue graspers. Scissors are used to dissect tissue, transect ligated vessels or other bodily ducts (such as fallopian tubes), trim sutures and ligatures and to perform other cutting functions. Graspers or forceps are used to coagulate and to grip and manipulate tissue and also to perform a variety of blunt dissecting procedures. Tissue is either grasped and pulled away from substrate tissue to which it is loosely connected or the blunt tips of the closed graspers are inserted between loosely connected tissue strata and then the tips are forced apart separating the tissue strata. The operation of ordinary scissors and forceps is very familiar to surgeons and non-medical personnel alike and their function and operation are somewhat intuitive. This fact remains true when scissors or forceps are incorporated into a traditional laparoscopic instrument.
Traditionally, when tissue cutting procedures are required, a scissors type laparoscopic instrument is used, and, when tissue grasping procedures are required, a forceps type laparoscopic instrument is used. Thus, the surgeon must either employ two cannulas or switch instruments depending on whether cutting or grasping procedures are required.
To overcome this problem, those skilled in the art have developed surgical instruments with detachable scissors and forceps end assemblies, and surgical instruments with combined scissors and forceps end assemblies.
For example, U.S. Pat. No. 5,893,875 discloses a surgical instrument with replaceable end effector assemblies. To switch between tissue cutting and grasping procedures, however, the surgeon must withdraw the instrument from the patient and replace the scissors end effector assembly with a forceps end effector assembly. This practice of instrument exchange greatly increases the time it takes to complete a given surgical procedure.
An attempt to overcome this problem is disclosed by a combined cutting blade/forceps end assembly. See U.S. Pat. Nos. 5,456,684 and 5,908,420. In another prior art device, a cutting blade is extendable between two forceps. See U.S. Pat. Nos. 5,496,317 and 5,573,535. See also the BiCoag® bipolar cutting forceps available from Everest Medical, 13755 First Avenue North, Minneapolis, Minn. 55441-5454.
All of these devices suffer from the fact that the scissoring and grasping capabilities are poorer than that which is available separately in single function devices.
Moreover, surgeons will not generally use any surgical instrument which does not operate in the way expected or in a way which is not intuitive. When conventional surgical devices with scissor grips are used, it is expected that the action of closing the scissor grips closes the scissor blades for tissue cutting or brings the forceps jaws together to grasp the tissue between them. This is not the case with the devices discussed above. For example, in order to use the device disclosed in U.S. Pat. No. 5,573,535, the surgeon uses a scissor grip to operate the forceps jaws but must operate a separate lever to effect distal movement of the blade member to cut tissue. See the '535 patent, col. 5, lines 43-66.
Other shortcomings of prior art devices include their complexity and high manufacturing costs. High manufacturing costs are especially important in surgical devices because they are often used in connection with one procedure on a given patient and then discarded.
Still another problem associated with the prior art is the non-ergonomic nature of the handle assembly associated with certain prior art surgical instruments. Surgeons are reluctant to use any surgical instrument whose operation is not fairly self-evident, or is complex, and/or is not similar to the operation of previously used surgical instruments. Also, surgeons desire a surgical instrument which provides feedback—a positive indication that it is working as intended.
In one prior art example, U.S. Pat. No. 5,403,322, incorporated herein by this reference, discloses a tissue approximator having two pivoting tissue grasping jaws each of which close about a central plate. The handle assembly of this device includes left and right pivoting triggers: the left trigger operates one tissue grasping jaw and the right trigger operates the other tissue grasping jaw.
The structure of this handle assembly is completely different from typical prior art laparoscopic instruments which typically include a scissor type handle with a pivoting trigger spaced from a fixed trigger. Surgeons, however, familiar with scissor type handle assemblies, are reluctant to use laparoscopic instruments with non-scissor type handles.
SUMMARY OF THE INVENTION
It is therefore an object of this invention to provide a surgical instrument which operates in the way expected and the use of which is intuitive.
It is a further object of this invention to provide such a surgical instrument which does not require the surgeon to operate separate levers in order to effect tissue cutting or tissue grasping procedures.
It is a further object of this invention to provide a surgical instrument with a handle assembly whose operation is self-evident, simple, and similar to the operation of previously used surgical instruments.
It is a further object of this invention to provide such a surgical instrument a handle assembly which provides a positive indication that it is operating as intended.
It is a further object of this invention to provide such a surgical instrument handle assembly which, in one embodiment, comprises an end effector assembly with a pivoting scissor blade and a pivoting tissue grasping jaw, which locks the scissor blade closed when the tissue grasping jaw is operated and, conversely, which locks the tissue grasping jaw closed when the scissor blade is operated.
It is a further object of this invention to provide such a surgical instrument in which altho
Evans Stephen C.
Hunt Robert B.
Melsky Gerald S.
Whipple Gary
Wisdom Richard
Iandiorio & Teska
Truong Kevin T.
LandOfFree
Surgical instrument does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Surgical instrument, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Surgical instrument will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-3025322