• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    SURGICAL DEVICE WITH REUSABLE HANDLE. The present invention relates to a laparoscopic surgical device which is provided including an axis comprising a removable tool having an external axis and an internal actuator plunger that can be, removably or permanently, connected. A device handle comprises a one-button / two-button mechanism for engaging and disengaging the shaft comprising a removable tool. The two-button mechanism is configured to engage corresponding overlapping openings in the external axis and plunger, which extend through the external axis.
    公开号:BR112012031391B1
    申请号:R112012031391-6
    申请日:2011-05-31
    公开日:2020-11-03
    发明作者:How-Lun Chen；Jesse Crumley；Robert F. Leonard
    申请人:Carefusion 2200, Inc；
    IPC主号:
    专利说明:

    Field of the Invention
    [0001] The present invention generally relates to medical devices and, more particularly, to a reusable handle configured to handle a tool end assembly removable from a laparoscopic surgical device. Background of the Invention
    [0002] As shown in figure 1, a typical monopolar electrosurgical laparoscopic tool device 100 generally has five main components: a handle 102, an external axis 104, which extends longitudinally from the handle, an actuating rod 106, which extends through the external axis; an electrode 108 in electro-conductive contact with the actuating rod; and an actuating end effector 110, disposed at the distal end of the device. The illustrated handle 102 is a right hand handle, having a stationary finger portion 112, affixed to the external axis 104, and an actuable thumb portion 114, affixed to the actuating rod 106. The performance of the thumb portion 114, affixed to the pivoting actuating rod relative to finger portion 112, moves actuating rod 106 axially within outer axis 104, to operate end effector 110. Although many different variations of each of the above components have been introduced in the art, there is a need solutions that provide manufacturing efficiency, and grant surgeons and other users ergonomic aspects, which increase safety and facilitate its use. In particular, there is a need for a handle that includes a locking component that allows a secure attachment and convenient detachment of the end tool assembly. Brief Summary
    [0003] Configurations of the present invention are configured to meet the needs in the art with respect to an ergonomic design, which gives advantages with respect to manufacture and use. Preferred configurations of the invention can be configured so that tool sets can be cleaned, sterilized if reused, or discarded after use. The most preferred configurations of the present invention include an end tool retention mechanism, actuated to engage a one-piece / two-piece end assembly that can be released using a two-button component of the retention mechanism. The retention mechanism provides a secure engagement of an external shaft and an internal actuator plunger at one end of the tool, as well as a handle, which can be reusable. In certain configurations, reusable end tool sets can also be used. Although the configurations of the invention discussed here are directed to the characteristics of a handle for a laparoscopic surgical device, those skilled in the art should appreciate which handle and effector configurations (needle holder, clamps, scissors, dissectors, handles, etc.) can be used. be practiced within the scope of the present invention,
    [0004] In one aspect of the present invention, configurations of a laparoscopic surgical device handle may include an end tool body, including an internal actuating rod arranged with reciprocal movement in a longitudinal lumen of an external axis, where the distal ends of plunger and shaft can be permanently or removably attached. Brief Description of Drawings
    [0005] Figure 1 shows a prior art laparoscopic tool device; figure 2 shows a disassembled view of the first configuration of a laparoscopic device; figure 2A shows a cross-sectional view taken along line 2A-2A of figure 2 of the tool end retention mechanism of the first handle configuration; Figure 2B is a longitudinal section view of a proximal portion of the tool-end body axis taken along the line 2B-2B of Figure 2; figure 2C shows a detail view of a proximal end portion of the actuating rod of the device of figure 2; figures 3A and 3B show a section view as in figure 2A, illustrating an assembly method; and figure 3C shows a distal end connection configuration between the actuating rod and the tool end shaft body; figure 4 shows a detailed perspective view of figure 3C; figures 5A, 5B, 5C show, respectively, side view, top view, and cross section view of an internal axis configuration. Detailed Description
    [0006] The outside of a first configuration of a laparoscopic surgical device 200 is illustrated with reference to figures 2-2C. As shown in figure 2, a disassembled view of a three-part configuration, a handle 210 includes a thumb ring member 204 (commonly called a "thumb ring") pivotally affixed to a pivot pin 208 to a ring member 206 (commonly called “finger ring”). Handle members 204, 206 are preferably held apart by a torsion spring or leaf spring. The thumb ring and finger ring members 204, 206 are made of resin, but alternatively they can also be made of materials known in the art, suitable for multiple autoclave sterilizations. A single use configuration can be made from a plurality of materials known in the art, but not necessarily configured for multiple sterilizations. Device 200 can be configured as a monopolar or bipolar instrument, configured for cutting and electrocautery / coagulation, including Bovie 207 rod or other electrode connection. A button 212 configured to rotate around its longitudinal geometric axis in an indexed and smooth manner (several constructions are known in the art) can be included at the distal end of handle 210.
    [0007] A tool end body including an elongated tubular outer shaft 240 extends distally from the finger ring member 206. An actuator stem 260 extends axially from the thumb ring means 204 through a longitudinal lumen of the shaft 240, and includes a tool lip 270 at its distal end. At the distal end of the device 200, an end effector 264 is operatively connected to the axis 240 and the actuator plunger 260. The connection of the actuator stem 240 can be permanent or removable (i.e., threaded bayonet, by fitting, or other connections). The 240 axis is preferably configured for use with laparoscopic trocars for abdominal procedures and other minimally invasive laparoscopic techniques (i.e., standard configurations can have an outside diameter of about 5 mm to about 100 mm). All components of the preferred configurations will be configured to maintain desirable fluid-sealing conditions for use during a procedure on an insufflated patient. Handle 210 may include one or more toothed mechanisms, configured to assist the user in positioning and operating device 200. A detailed representation of handle construction, as well as examples of toothing and other retention / manipulation mechanisms that can be used within the scope of the present invention includes those described in US Patent Application Publication No. 2007/0299469 by Carpenter et al. incorporated into this by reference.
    [0008] Figure 2A is a partial longitudinal section view of handle 210 along line 2A-2A, showing the handle portion of an engagement mechanism for releasably connecting the axis of the tool body 240 to handle 210. A channel central 211 extends through button 212 and upper portion of the member and finger ring handle 206. Channel 211 is configured to receive the proximal end of the external axis of tool body 240 and internal actuator plunger 260. The thumb ring 204 includes aperture 205, configured as a ball cage that is configured to capture the proximal end ball 262 of actuator stem 260.
    [0009] The button 212 substantially houses the axle engagement portion and plunger engagement portion of the engagement mechanism (the ball cage 205 of the thumb ring 204 is not considered part of the engagement mechanism for the purpose of the present invention, although has the important function of attaching / acting the internal stem 260). The button includes two opposing buttons 216, 222. As shown in figure 2A, the first button 216 is affixed and disposed opposite a two-tooth retaining member 218, which includes teeth 219 which are raised to the first button 216 in the channel 211.0 second button 222 is attached and disposed opposite a retaining member a tooth retaining member 224 which includes a tooth 225, which is lowered to the second button 222 in channel 211. As shown, the retaining members and their teeth (collectively called shutters) are permanently attached to handle 211, in direct mechanical communication with their respective buttons. The performance of the retaining members will be described below with reference to figures 3A and 3B. The force for each retaining member, as shown, is provided by helical springs, but other means can be used, as known in the art.
    [00010] Figure 2B shows a longitudinal section view of the tool end body shaft (taken along line 2B-2B) of the proximal portion of the tool end body shaft assembly 240. In this configuration, a portion inner part 242 of shaft 240 is metallic and the outer cover portion 244 includes an electro-insulating polymer. In the configuration shown, which is the configuration with the largest external diameter, the outer layer 244 is separated from the inner portion 242 of the axis 240, but in certain configurations with a smaller outer diameter, the outer layer 244 can contact directly and / or be built over the internal shaft portion 242. A nose portion 246 configured to be received in a complementary cavity of button 212 is mounted near the end of the proximal axis. The nose portion 246 includes a flush port 247, which provides fluid communication with the longitudinal lumen 250, which extends across the length of the axis 240. An extreme proximal end portion of the axis 240, configured to be received in the handle channel 211, includes at least first and second openings that are at least partially opposite. In the configuration shown in figures 2-3C, the first opening is configured as a pair of openings 249, which are configured to align and receive the first retaining member tooth 219. The second opening is configured as opening 255, disposed opposite the first opening, and configured to align and receive the second retaining member tooth 225.
    [00011] Figure 2C shows an external view from top to bottom of the proximal portion of the actuating stem. A ball 262 or other enlarged structure is arranged at the proximal end, configured for capture by the upper end of the thumb ring handle member 204. The ball 262 may include a handle member of larger outside diameter 204. The ball 262 may include a outside diameter larger than the plunger portion 260 immediately distally adjacent to the sphere. The inner rod 260 is configured to be slidably disposed through the lumen of the shaft 250. As shown, a proximal plunger length can include an outside diameter greater than most of the length of the shaft 260 which facilitates inlay of the lumen of the shaft 250, with the rod not being removed from it while providing a desirable proximal seal between them. The pivotal actuation of the thumb ring 204 in relation to the thumb ring 206 causes longitudinal reciprocation of the inner shank 260 in relation to the axis 240. At the distal end, shank 260 includes a tool assembly 270, which is configured to be attached to the external axis 240. This fixation can be removable, as described below with reference to figure 3C, or permanent, so that axis 240 and plunger 260 can be attached / removed from handle 210, as an independent unit. Configurations, where plunger and shaft are permanently connected, can be provided so that the distal plunger / shaft / tool set is either disposable after use, or cleaned and sterilized for subsequent use. Many different tool tip sets 270 are known in the prior art for use / actuation with a reciprocal inner shank and relatively fixed outer shaft. Tips include clamps, handles, scissors, or other tools currently known or to be developed, for use within the scope of the present invention. The inner rod 260 may be provided in a single piece or made up of multiple pieces, including those one or more portions (in addition to the proximal sphere 262, they may have an outside diameter greater than most of the length of the plunger).
    [00012] A proximal region of the stem 260 includes an elongated inner groove or groove opening 267. The inner groove opening 267 is shown to be generally oblong, but may have a different geometry, including a shape configured as a pair of opposite grooves, that do not extend over the entire stem (not shown, but easily understood by those skilled in the art, including a longitudinal wall between opposite faces of opening 267), which is configured to receive the ends of the first and second limb teeth. retention 219, 225. When teeth 219, 225 are engaged with the internal stem opening 267, they allow the stem to reciprocate longitudinally, but generally prevent stem 260 from rotating about its geometric axis. Thus, when teeth 219, 225 are engaged through the external shaft opening at the internal plunger opening 267, the teeth (i) generally hold the external shaft 240 in a fixed longitudinal and rotational position relative to handle 210, and (ii ) generally keep the inner stem 260 in a fixed rotational position in relation to the outer axis 240 and handle 260, and allow the stem to reciprocate longitudinally in relation to handle 210 and outer axis 240, with the pivoting action of the thumb ring 204 in relation to to the finger ring 206. This structure and its functionality will be described below with reference to an assembly method of the device 200.
    [00013] In most configurations, thumb ring 204 rotates relative to finger ring 206 in a single plane. However, handle constructions are known in the art where non-planar rotation can be used. Preferred configurations of the device 200 include arranging an insulating material along the entire length of the handle, and on other surfaces in the proximal region, which conduct current, when the device is configured as an electrosurgical device, and connected to an electrical power source. As shown in figure 3B, discussed above, in configurations where a nose portion is used, the device is permanently attached to the external axis and prevents the external axis from rotating in relation to the engagement mechanism (if the engagement mechanism is arranged in a index button, as shown, or on a fixed portion of handle assembly 210).
    [00014] A method for mounting the device 200 of figures 2 and 2C will be described with reference to figures 3A to 3C. In figure 3A, the thumb ring 204 is shown away from the thumb ring 206. This orientation exposes the opening of the top end of the ball cage 205 aligned with the proximal end of the longitudinal handle channel 211. The inner rod 260 is arranged through from the axis lumen 250, longitudinally directed to the handle channel 211. The first and second buttons 216 and 222 are pressed towards the central longitudinal geometric axis of the engagement mechanism on the index button 219 of the two-tooth retaining member 218 downwards and out of the handle channel 211. Similarly, this actuation of the second button 222 moves the tooth 225 of the second retaining member 224 upwards and out of the handle channel 211.
    [00015] With the retaining teeth 219, 225 out of the way, the handle channel 211 allows the inner rod 260 and the outer shaft 240 to advance proximally until the proximal ball 262 of the rod is captured in the ball cage 205. As shown in figure 3A, one or more teeth 219, 225 may have an angled, bent, or rounded distal surface, so that stem 260 and / or axis 240 can more readily approach, dislodge, or pass teeth, even if buttons 216, 222 are not initially fully tightened. Thumb ring 204 can be loosened and directed / pivoted downward towards thumb ring 206, fully capturing ball 262 in ball cage 205, which has a keyhole-shaped cross section, so that a the larger proximal portion engages the ball 262, while a narrower distal portion prevents the ball from being released distally when the thumb ring 204 rotates downward, as in figure 3B. The ball cage 205, preferably, should not interfere with the action of the handle members, nor with the rotation of the inner rod 260, around its longitudinal geometric axis. The elongated inner stem opening 267 visible in figure 3A, with stem 260 and outer axis 240 being shown out of the rotational position around 90 °, which allows the retaining teeth 219, 225 to engage the inner stem opening 267, through the external shaft openings 249, 255.
    [00016] Figure 3B shows the tool body assembly including the outer shaft 240 and the inner stem 260 fully advanced proximally. The axis 240 and plunger 260 are rotated and the buttons 216, 222 are released, so that (i) the shaft openings 249, 255 are aligned with the inner stem opening 267; (ii) the retaining teeth 219, 225 are extended to their respective extended positions to engage the internal shaft opening 267 through the external shaft openings 249, 255; and (iii) the nose portion 246 is aligned and engaged with the indexing button 212. As shown in this configuration, the engaged position of the inner stem 260 reciprocates longitudinally with respect to the external axis 240 and finger ring 206, longitudinally fixed to each other . In one configuration, when the indexing knob can rotate, knob 212, outer axis 240, and inner stem 260 rotate with respect to handle 210, about the mutual geometric axis.
    [00017] Figure 3C shows a connection construction for device configurations 200, where the internal rod 260 is removable from the external axis 240, instead remaining permanently attached distally to it. Tool tip 270 is shown as a handle set, but it can also be scissors, biopsy forceps, or any of a number of other laparoscopic tool tips. The proximal base 272 of the tool tip body is generally cylindrical, and includes a bayonet groove having a longitudinal groove portion 274 and a radial groove portion 272. Figure 3C also shows the distal end of the outer axis 240, which includes a distal opening 257, configured to loosely receive point base 272. A pin 258, which engages the groove, extends radially towards opening 257. Figure 4 shows a detailed perspective view of figure 3C.
    [00018] When the actuating rod 260 is directed to the axis lumen 250, the pin 258, which engages the groove, can be guided to the distal end of the longitudinal bayonet groove portion 274, and then the tool tip rotates to engage pin 258 with the end of the radial groove portion 275. The bayonet mechanism, including pin and groove, is preferably provided, so that pin 258 fully engages the end of groove 275, making the rotational position of the inner rod 250 align the proximal opening 267 with the external shaft openings 249, 255. It should be appreciated that one or more bayonet pins can be used in various configurations. In other configurations, a threaded connection including a Luer connection that requires only a fraction of a turn to engage (that is, a quarter turn) or traditional threads (many turns), pressure adjustment, reverse bayonet, and / or other structures connecting shaft 240 and piston 260, without departing from the scope of the present invention. Regardless of whether the shaft and shaft engage a handle or not, it is preferable that the distal connection of the external shaft be configured to engage the distal regions of the internal shaft and external shaft, when the opening of the internal shaft is rotationally aligned with at least one of the openings external stem.
    [00019] Figures 5A and 5C show another configuration of an internal actuating rod including a proximal end ball 562 with a region 563 immediately distally adjacent to ball 562, which has a smaller outside diameter than the adjacent portion after rod 560, and these transitions thereof with a longitudinal central axis of the shaft 560. Instead of opening 267, as discussed above with reference to the internal shaft configuration 260, this configuration includes a narrowed piston portion 567 having a rectangular cross-sectional geometry , as in figure 5C (sectional view of figure 5A along line 5C-5C).
    [00020] It should be appreciated that this piston configuration can be used in connection with a handle, i.e., handle 210. In this application, teeth 219, 225 engage faces 567a, 567b in the narrowed portion 567 (when oriented relatively horizontally) , as shown in figure 5A) or can be modified to include generally vertical longitudinal grooves (not shown) configured to engage around the narrowed plunger portion 567 (in a configuration where the flat portion is oriented relatively vertically, as in figure 5B; of course, the distal end in figures 5A and 5B can be configured to properly engage the tool / effector tip, as is well known in the art).
    [00021] Those skilled in the art should appreciate that there are a number of different ways to control the relative position / movement of the toothed members described above, which are appropriate for use within the scope of the invention, and that different materials may be useful for settings. Those skilled in the art will also appreciate that for the handle configurations of the present invention, the thumb ring member and / or finger ring member may not require a closed ring structure, but include an open ring or other closed ring structure for the user's thumb and fingers, respectively. It is intended that the detailed description above is taken for illustrative purposes, rather than limiting.
    [00022] Those skilled in the art should appreciate that configurations not expressly illustrated in this can be practiced within the scope of the present invention, including components described for different configurations, which can be configured with currently known technologies or to be developed in the future, while remaining within the scope of the claims presented. Accordingly, it is intended that the following claims, including their equivalents, define the spirit and scope of the present invention. Furthermore, the advantages described above are not necessarily the only advantages offered by the present invention, and it is also not expected that all the advantages described will be achieved in each configuration of the present invention.
    权利要求:
    Claims (18)
    [0001]
    1. Surgical instrument (200), comprising: a handle (210) comprising: a first handle member (206); a second handle member (204) pivotally attached to the first handle member (206) configured to pivot with respect to it; a body comprising: a tubular outer axis (240) removably attached to the first handle member (206); an internal rod (260) extending through a longitudinal lumen (250) of the external axis (240) and removably attached to the second handle member (204) in order to allow a reciprocal longitudinal movement in relation to the external axis (240); and a latching mechanism configured to provide a releasable connection between the handle (210) and the body, comprising: at least a first external shaft opening (249) and a second external shaft opening (255), which are at least partially opposite and are arranged through a proximal region of the external axis (240); a first tooth (218) permanently attached to the first handle member (206) and moved into a releasable engagement with at least one first external shaft opening (249); a second tooth (224) permanently affixed to the first handle member (206), at least partially opposite the first tooth (218), and moved to a releasable engagement with at least a second external shaft opening (255) ; characterized by the fact that the instrument (200) is configured in such a way that, pivoting one of the first and second handle members (206, 204) in relation to the other, the internal rod (260) is moved longitudinally in relation to the external axis ( 240); wherein the inner rod (260) still comprises a proximal inner rod opening (267) that is configured to align with at least one of the outer rod openings (249, 255), and to receive at least one of the first and second teeth (218, 224), while allowing the inner rod (260) to move longitudinally in relation to the external axis (240), when the handle (210) is actuated by pivoting one of the handle members (204, 2016) in relation to the other.
    [0002]
    2. Surgical instrument, according to claim 1, characterized by the fact that the handle (210) still comprises an indexing button (212) configured to rotate the body around its longitudinal geometric axis and in which when the instrument is mounted , the indexing button (212) houses the coupling mechanism.
    [0003]
    3. Surgical instrument, according to claim 1 or 2, characterized by the fact that the first and second teeth (218, 224) are operatively associated with first and second buttons (216, 222) respectively, in which the performance of each of the said buttons (216, 222) is configured to counter the force of its corresponding tooth (218, 224), and disengage from a corresponding external shaft opening (249, 255).
    [0004]
    4. Surgical instrument according to any one of the preceding claims, characterized by the fact that it still comprises a tool tip (270) affixed to a distal portion of the external axis (240) and the internal shaft (260).
    [0005]
    5. Surgical instrument, according to claim 4, characterized by the fact that the attachment of the tool tip (270) to the external axis (240) is removable.
    [0006]
    6. Surgical instrument, according to any of the previous claims, characterized by the fact that it still comprises a first button (216) in direct mechanical communication with the first tooth (218) and configured so that the actuation of the first button (216 ) opposes the force of the first tooth (218), and disengages a first opening of the external axis (249).
    [0007]
    7. Surgical instrument, according to claim 6, characterized by the fact that it still comprises a second button (222) in direct mechanical communication with the second tooth (224), and configured so that the second button's action opposes the force second tooth (224), and disengage the second external shaft opening (255).
    [0008]
    8. Surgical instrument according to any one of the preceding claims, characterized by the fact that a proximal end of the inner nail (260) includes an outer diameter greater than most of the length of the inner nail (260).
    [0009]
    Surgical instrument according to any one of the preceding claims, characterized in that the second handle member (204) comprises an opening (205) configured to capture and secure the proximal end of the inner nail (260).
    [0010]
    10. Surgical instrument, according to any one of the preceding claims, characterized by the fact that the internal stem still comprises a distal connection with the external axis (240) configured to engage the internal stem (260) with the external axis (240), when the internal stem opening (267) is rotationally aligned with at least one of the external shaft openings (249, 255).
    [0011]
    11. Handle for a laparoscopic surgical instrument (200), the handle comprising: a first handle member (206); a second handle member (204) pivotally attached to the first handle member (206), configured to pivot with respect to it along a single plane; and an engagement mechanism configured to provide a releasable connection between the first handle member (206) and an axle body (240), the engagement mechanism comprising: a channel receiving the body (211) configured to receive a longitudinally end proximal to the shaft body (240); a first tooth (218) permanently affixed to the first handle member (206), and forced to extend, at least partially, into the channel that receives the body (211), in which the first tooth (218) is attached a and disposed opposite a first reciprocal button (216) configured to act on the first tooth (218) opposite to its force; a second tooth (224) permanently affixed to the first handle member (206), at least partially opposite the first tooth (218), and forced to extend, at least partially, in the channel that receives the body (211) ; characterized by the fact that the second handle member (204) includes an opening (205) configured to capture and secure a proximal end of an actuating rod (260).
    [0012]
    12. Handle, according to claim 11, characterized by the fact that the first handle member (206) comprises an indexing button (212) configured to rotate in relation to it around a longitudinal geometric axis of the channel receiving the body (211).
    [0013]
    13. Handle, according to claim 12, characterized by the fact that the engagement mechanism is comprised of an indexing button (212), and the first reciprocal button (216) extends in a depressible reciprocal manner therefrom.
    [0014]
    14. Handle, according to claim 11, characterized by the fact that it still comprises an internal actuating stem (260) removably affixed to a proximal stem end for the second handle member (204).
    [0015]
    15. Handle, according to claim 14, characterized by the fact that a distal end of the actuating rod (260) comprises a surgical tool tip (270).
    [0016]
    16. Handle according to claim 15, characterized in that it still comprises an external axis (240) removably affixed at a proximal end to the first handle member (206).
    [0017]
    17. Handle according to claim 16, characterized in that a distal end of the external axis (240) is removably attached to the tool tip (270).
    [0018]
    18. Handle according to claim 16, characterized by the fact that a distal end of the external axis (240) is permanently attached to the tool tip (270).
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    同族专利:
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    法律状态:
    2018-12-26| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2019-08-06| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2020-04-07| B06A| Notification to applicant to reply to the report for non-patentability or inadequacy of the application [chapter 6.1 patent gazette]|
    2020-08-25| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2020-11-03| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 31/05/2011, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US12/797,933|2010-06-10|
    US12/797,933|US8956341B2|2010-06-10|2010-06-10|Surgical device with reusable handle|
    PCT/US2011/038506|WO2011156168A1|2010-06-10|2011-05-31|Surgical device with reusable handle|
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