Surgical instruments

Details Surgical instruments Surgical instruments

1998-03-17

2001-02-13

Buiz, Michael (Department: 3731)

Surgery

Instruments

Forceps

Reexamination Certificate

active

06187026

ABSTRACT:

FIELD OF THE INVENTION
This invention relates to surgical instruments, for use in laparoscopic or endoscopic surgery and/or open surgery.
BACKGROUND OF THE INVENTION
Laparoscopic and endoscopic surgical methods have become increasingly popular in recent years. Such methods typically involve making small incisions in the abdominal wall of a patient through which specially designed laparoscopic or endoscopic tools are inserted for carrying out the surgical procedure. Such tools typically have a miniaturised surgical implement such as forceps or scissors at the end of a long shaft to the other end of which is attached a handle and actuating mechanism. By the use of such tools, the surgeon can operate the instrument from outside the patient's body whilst monitoring the movement of the surgical tool within the body by means of an endoscope.
Such techniques of minimally invasive therapy (MIT), which have been commonly referred to as keyhole surgery, offer very substantial advantages over conventional open surgery in that only very small incisions in the patient's body wall are required thus substantially minimising patient trauma, dramatically reducing post-operative complications, and greatly reducing the opatient's recovery time.
As laparoscopic or endoscopic surgical techniques are generally more delicate than those of open surgery, the surgical instruments need to be particularly easy in manipulate and use. Hitherto, the surgical instruments used in MIT have been cumbersome to use. For example, many conventional laparoscopic instruments have off-centre scissor handles for actuating the surgical tool. The presence of such scissor-handle actuated mechanisms makes steady control and rotation of the instrument difficult. To overcome this problem, some tools are provided with a thumb wheel by which the actuator shaft is rotated independently from the scissor handles. However, such an arrangement is clumsy to use and often requires two hands to operate effectively. Thus, there remains a need for surgical instruments for use in surgery which are more easily manipulated, can be operated entirely by one hand, can be rotated freely, and operated just as effectively in any rotated position to enable the orientation of the surgical tool to be varied as required. It is an object of the present invention to provide such an instrument.
SUMMARY OF THE INVENTION
The present invention is based in part on the recognition that a surgical instrument can be manipulated with greater control and sensitivity when the instrument is held in a pen-like grip, i.e. with the non-functioning end of the instrument extending rearwardly from between the thumb and forefinger. Furthermore, the invention is based on the recognition that a surgical instrument can be made more responsive and easier to use if it can be rotated by the fingers to any position and can be actuated from a position anywhere around the circumference of the handle of the instrument. This is in contrast to existing surgical tools such as those disclosed in, for example EP-A-0535370 and EP-A-0598202, in which either a squeeze grip type actuation mechanism is provided, or an actuator lever is provided at a single location on the circumference of the instrument handle.
Accordingly, in a first aspect the invention provides a surgical instrument comprising a handle shaped to enable it to be freely rotated by the user's fingers a-cut its longitudinal axis in the hand of the user, and held by the user at any angle of rotation about its longitudinal axis; the handle having an elongate shaft extending therefrom and a surgical tool mounted on the shaft at a location remote from the handle; the handle being provided with actuator means operatively linked through the shaft to the surgical tool; the actuator means having an actuator surface or surfaces extending around substantially the entire circumference of the handle, whereby the actuator means is operable by applying pressure at substantially any circumferential location on the actuator surface or surfaces, to actuate the surgical tool.
The handle may be of generally circular cross-section, or it may be of a non-circular cross-section. For example it may be of polygonal cross-section, eg hexagonal or octagonal, but most preferably it is circular in cross-section. The term circumference as used herein is intended to refer to the perimeters of both circular and non-circular handles.
The actuator surface may be a continuous surface extending around the circumference of the handle or it may, alternatively, comprise an array of closely spaced discrete actuator elements.
The actuator means may be mechanical, electrical, pneumatic or hydraulic or any combination of these.
In one particular example of a mechanical arrangement, the actuator means is mechanically linked to an actuating rod disposed slidably within the elongate shaft, which rod is in turn linked to the surgical tool on the end of the shaft.
In one particular example of an electrical arrangement, the actuator means may comprise a switch or array of switches for controlling the flow of electrical current along the shaft to a diathermy tool (e.g. a diathermy hook) at the end thereof.
The surgical tool mounted at the end of the elongate shaft may be any one of the types of surgical tools conventionally used in laparoscopic or endoscopic surgery. Thus, for example, the surgical tool may be a miniaturised surgical instrument such as a pair of forceps, a clamp, a pair of scissors or a diathermy hook. Any of the aforesaid tools may optionally have a monopolar or bipolar diathermy capability.
The actuator means in one embodiment can be an array of radially displaceable actuator elements disposed around the circumference of the handle, means being provided for converting radial inward movement of an actuator element into longitudinal movement of the actuating roc within the elongate shaft.
For example, the actuator element may be provided with an edge or surface which functions as a cam follower or camming surface, for engaging and camming against a complimentary camming surface or cam follower associated with the actuating rod.
In one embodiment, each actuator element is provided with a wedging member having an inclined surface whereby radially inward movement of the actuator element urges the inclined surface of the wedging member into contact with a camming edge or surface associated with the actuator shaft, thereby to displace the camming edge or surface in a longitudinal direction.
A sufficiently large number of actuator elements are disposed around the circumference of the handle to ensure that the instrument can be actuated from substantially any location around its circumference. For this purpose, a minimum of three actuator elements is generally required, but preferably there are more than three actuator elements disposed around the circumference, more preferably there are at least six actuator elements, and in one particularly preferred embodiment there are eight actuator elements. In another particularly preferred embodiment, there are twelve actuator elements.
The handle is preferably of elongate form and is sufficiently small in cross section to enable it to be held in a pen-like grip, i.e. wherein the end of the handle remote from the actuator shaft extends away from the hand between the thumb and adjacent finger.
The handle may typically have a bulbous shape, being tapered towards the end remote from the surgical tool, increasing in diameter towards the central portion thereof and tapering again towards the actuator shaft. The actuator means typically is located within the bulbous or enlarged diameter central region of the handle.
The handle may be provided with means for effecting locking of the surgical tool in a given configuration. For example, where the surgical tool is in the form of a miniature pair of grasping forceps or a clamping tool, the locking means may be effective to lock the forceps or clamping tool in a clamping or gripping configuration.
In one embodiment, the handle is provided with first actuator mea

Affiliated with

Also associated with

Rating

Surgical instruments 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 instruments, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Surgical instruments will most certainly appreciate the feedback.

Rate now

Comments { 0 }

Profile ID: LFUS-PAI-O-2589033