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    • 专利摘要:
    articulating joint elements for a particular surgical device. The present invention relates to an electrosurgical device comprising a frame, an end effector, a cutting element, and a rod. the end effector includes a pair of claws that are intended to supply rf energy to tissue that is trapped between the claws. the cutting element is intended to cut the fabric that is trapped between the claws. the rod extends between the frame and the end effector. the rod includes an articulation section intended to selectively position the end effector in non-parallel positions with respect to the longitudinal axis of the rod. some versions include a rotation section that is distal to the hinge section. the rotation section is intended to rotate the end effector in relation to the articulation section.
    公开号:BR112013006517B1
    申请号:R112013006517-6
    申请日:2011-09-22
    公开日:2021-08-10
    发明作者:Barry C. Worrell；David K. Norvell；Charles J. Scheib；Frederick E. Shelton Iv；Geoffrey S. Strobl；Jeffrey S. Swayze；Gregory A. Trees；Jason E. Zerkle；Kevin M. Montgomery
    申请人:Ethicon Endo-Surgery, Inc；
    IPC主号:
    专利说明:

    PRIORITY
    [0001] This application claims priority to U.S. Provisional Application Serial No. 61/386,117, filed September 24, 2010, entitled "Articulating Surgical Device," the description of which is incorporated herein by reference. BACKGROUND
    [0002] The present invention relates to various surgical instruments including a tissue cutting element and one or more elements that transmit RF energy to tissue (for example, to coagulate or seal tissue). An example of such a device is the ENSEAL® fabric sealing device obtained from Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio, USA Additional examples of such devices and related concepts are set forth in US Patent No. 6,500,176 entitled "Electrosurgical Systems and Techniques for Sealing Tissue," issued December 31, 2002, the description of which is incorporated herein by reference; US Patent No. 7,112,201 entitled "Electrosurgical Instrument and Method of Use," issued September 26, 2006, the disclosure of which is incorporated herein by reference; US Patent No. 7,125,409 entitled "Electrosurgical Working End for Controlled Energy Delivery," issued October 24, 2006, the description of which is incorporated herein by reference; US Patent No. 7,169,146 entitled "Electrosurgical Probe and Method of Use," issued January 30, 2007, the disclosure of which is incorporated herein by reference; US Patent No. 7,186,253 entitled "Electrosurgical Jaw Structure for Controlled Energy Delivery," issued March 6, 2007, the disclosure of which is incorporated herein by reference; US Patent No. 7,189,233 entitled "Electrosurgical Instrument," issued March 13, 2007, the disclosure of which is incorporated herein by reference; US Patent No. 7,220,951, entitled "Surgical Sealing Surfaces and Methods of Use," issued May 22, 2007, the disclosure of which is incorporated herein by reference; US Patent No. 7,309,849 entitled "Polymer Compositions Exhibiting a PTC Property and Methods of Fabrication," issued December 18, 2007, the description of which is incorporated herein by reference; US Patent No. 7,311,709 entitled "Electrosurgical Instrument and Method of Use," issued December 25, 2007, the disclosure of which is incorporated herein by reference; US Patent No. 7,354,440 entitled "Electrosurgical Instrument and Method of Use," issued April 8, 2008, the disclosure of which is incorporated herein by reference; US Patent No. 7,381,209 entitled "Electrosurgical Instrument," issued June 3, 2008, the disclosure of which is incorporated herein by reference; US Publication No. 2011/0087218 entitled "Surgical Instrument Comprising First and Second Drive Systems Actuatable by a Common Trigger Mechanism," published April 14, 2011, the description of which is incorporated herein by reference; and U.S. Patent Application No. 13/151,181 entitled "Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback," filed June 2, 2011, the description of which is incorporated herein by reference.
    [0003] In addition, several surgical instruments include a stem that has a pivot section, providing enhanced positioning capabilities for an end effector that is located distally to the pivot section of the stem. Examples of these devices include various models of ENDOPATH® endocutters obtained from Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio, USA Additional examples of these devices and related concepts are set forth in US Patent No. 7,380,696 entitled "Articulating Surgical Stapling Instrument Incorporating a Two-Piece E Beam Firing Mechanism," granted June 3, 2008, the description of which is incorporated herein by reference; US Patent No. 7,404,508 entitled "Surgical Stapling and Cutting Device," issued July 29, 2008, the disclosure of which is incorporated herein by reference; US Patent No. 7,455,208 entitled "Surgical Instrument with Articulating Shaft with Rigid Firing Bar Supports," issued November 25, 2008, the disclosure of which is incorporated herein by reference; US Patent No. 7,506,790 entitled "Surgical Instrument Incorporating an Electrically Actuated Articulation Mechanism," issued March 24, 2009, the description of which is incorporated herein by reference; US Patent No. 7,549,564 entitled "Surgical Stapling Instrument with an Articulating End Effector," issued June 23, 2009, the disclosure of which is incorporated herein by reference; US Patent No. 7,559,450 entitled "Surgical Instrument Incorporating a Fluid Transfer Controlled Articulation Mechanism," issued July 14, 2009, the description of which is incorporated herein by reference; US Patent No. 7,654,431 entitled "Surgical Instrument with Guided Laterally Moving Articulation Member," issued February 2, 2010, the description of which is incorporated herein by reference; US Patent No. 7,780,054 entitled "Surgical Instrument with Laterally Moved Shaft Actuator Coupled to Pivoting Articulation Joint," issued August 24, 2010, the description of which is incorporated herein by reference; US Patent No. 7,784,662, entitled "Surgical Instrument with Articulating Shaft with Single Pivot Closure and Double Pivot Frame Ground," issued August 31, 2010, the description of which is incorporated herein by reference; and US Patent No. 7,798,386 entitled "Surgical Instrument Articulation Joint Cover," issued September 21, 2010, the description of which is incorporated herein by reference.
    [0004] Although various medical devices have been made and used, it is believed that no one before the inventors made or used the invention described in the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS
    [0005] Although the specification ends with claims that specifically indicate and distinctly claim this technology, it is believed that this technology will be better understood from the following description of specific examples taken in conjunction with the accompanying drawings, in which reference numerals similar identify the same elements and in which:
    [0006] Figure 1 represents a side elevation view of an exemplary electrosurgical medical device;
    [0007] Figure 2 represents a perspective view of the end effector of the device of Figure 1, in an open configuration;
    [0008] Figure 3 represents another perspective view of the end effector of the device of Figure 1, in an open configuration;
    [0009] Figure 4 represents an end view in cross section of the end effector of figure 2, in a closed configuration and with the blade in a distal position;
    [00010] Figure 5 represents a perspective view of an exemplary articulation section for the rod of the device of figure 1;
    [00011] Figure 6 represents an end cross-sectional view of the hinge section of Figure 5, along line 6-6 of Figure 5;
    [00012] Figure 7 represents a perspective view from above of another exemplary articulation section of the rod of the device of Figure 1;
    [00013] Figure 8 represents a perspective view from below of another hinge section of Figure 7;
    [00014] Figure 9 represents a top plan view of the articulation section of Figure 7;
    [00015] Figure 10 represents a perspective view of another exemplary articulation section for the rod of the device of figure 1;
    [00016] Figure 11 represents an exploded view of the hinge section of Figure 10;
    [00017] Figure 12 represents an exploded view of another articulation section for the rod of the device of figure 1;
    [00018] Figure 13 represents a plan view of the articulation section of Figure 12;
    [00019] Figure 14 represents a perspective view of another exemplary articulation section for the rod of the device of figure 1;
    [00020] Figure 15 represents a perspective view of a bead component of the hinge section of Figure 14;
    [00021] Figure 16 represents a top plan view of the bead component of Figure 15;
    [00022] Figure 17 represents a cross-sectional side view of the articulation section of Figure 14;
    [00023] Figure 18 is a partial perspective view of the distal end portions of the hinge section of Figure 14;
    [00024] Figure 19 is a partial perspective view of an upper portion of a distal rotation element associated with the hinge section of Figure 14; and
    [00025] Figure 20 represents a partial perspective view of a lower portion of the distal rotation element of Figure 19.
    [00026] The drawings are not intended to be limiting in any way, and it is contemplated that various modalities of the technology can be performed in a variety of different ways, including those not necessarily shown in the drawings. The attached drawings incorporated and forming part of the descriptive report illustrate various aspects of the present technology, and together with the description serve to explain the principles of the technology; it is understood, however, that this technology is not limited to the provisions shown. DETAILED DESCRIPTION
    [00027] The following description of certain examples of the technology should not be used to limit its scope. Other examples, characteristics, aspects, modalities, and advantages of the technology will become evident to those skilled in the art from the following description, which is intended as an illustration, one of the best ways contemplated to perform the technology. As will be understood, the technology described herein is capable of other different and obvious aspects, all without disregarding the invention. Consequently, the drawings and descriptions are to be regarded as illustrative in nature and not restrictive.
    [00028] It is further understood that any one or more of the teachings, expressions, modalities, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, modalities, examples, etc. which are described in the present invention. The teachings, expressions, modalities, examples, etc. described below should therefore not be seen in isolation from one another. Various suitable ways in which the teachings of the present invention may be combined will be readily apparent to those skilled in the art in view of the teachings of the present invention. These modifications and variations are intended to be included within the scope of the claims. I. Exemplary electrosurgical device with articulation element
    [00029] Figures 1 to 4 show an exemplary electrosurgical instrument (10) that is constructed and operable in accordance with at least some of the teachings of US patents 6,500,176; US Patent No. 7,112,201; US Patent No. 7,125,409; US Patent No. 7,169,146; US Patent No. 7,186,253; US Patent No. 7,189,233; US Patent No. 7,220,951; US Patent No. 7,309,849; US Patent No. 7,311,709; US Patent No. 7,354,440; US Patent No. 7,381,209; U.S. Publication No. 2011/0087218; and/or U.S. Patent Application No. 13/151,181. As described there and as will be described in more detail below, the electrosurgical instrument (10) is intended to cut tissue and seal or join tissue (e.g., a blood vessel, etc.) substantially simultaneously. In other words, the electrosurgical instrument (10) works similarly to a type of stapler endocutter, except that the electrosurgical instrument (10) provides tissue binding by applying bipolar RF energy rather than providing lines of staples to join the fabric. It should also be understood that the electrosurgical instrument (10) may have several structural and functional similarities to the ENSEAL® tissue sealing device obtained from Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio, USA In addition, the electrosurgical instrument (10) may have various structural and functional similarities to the devices taught in any of the other references that are cited and are incorporated by reference in the present invention. To the extent that there is some degree of overlap between the teachings of the references cited in the present invention, the ENSEAL® tissue sealing device from Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio, and the following teachings related to the electrosurgical instrument (10), the description of the present invention is not intended to be presumed prior art. Various teachings below, in fact, go beyond the scope of the teachings of the references cited herein and in the ENSEAL® tissue sealing device from Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio, U.S.A. A. Exemplary handpiece and rod
    [00030] The electrosurgical instrument (10) of the present example includes a handpiece (20), a rod (30) extending distally from the handpiece (20), and an end effector (40) disposed in a distal end of the rod (30). The handpiece (20) of the present example includes a pistol grip (22), a pivot actuator (24), an activation button (26), and a pivot control (28). The trigger (24) is pivoted towards and away from the pistol grip (22) to selectively trigger the end effector (40), as will be described in more detail below. The activation button (26) is intended to selectively activate the RF circuit that is in communication with the end effector (40), as will also be described in more detail below. In some versions, the activation button (26) also serves as a mechanical lock against the trigger (24), so that the trigger (24) cannot be fully activated unless the button (26) is pressed simultaneously . Examples of how such a lock may be provided are disclosed in one or more of the references cited in the present invention. It should be understood that the pistol grip (22), trigger (24), and button (26) can be modified, replaced, supplemented, etc. in any suitable way and that descriptions of such components of the present invention are merely illustrative. The pivot control (28) of the present example is intended to selectively control the pivot section (36) of the rod (30), which will be described in more detail below. Various examples of forms that pivot control (28) can take will also be described in more detail below, while additional examples will become apparent to those skilled in the art in view of the teachings of the present invention.
    [00031] The rod (30) of the present example includes an outer sheath (32) and a pivot section (36). The hinge section (36) is intended to selectively position the end effector (40) at various angles relative to the longitudinal axis defined by the sheath (32). The various examples of shapes that the hinge section (36) and the other components of the stem (30) can take will be described in more detail below, while additional examples will become apparent to those skilled in the art in view of the teachings of the present invention. For example, it should be understood that various components intended to activate the hinge section (36) may extend through the interior of the sheath (32). In some versions, the rod (30) is also rotatable about the longitudinal axis defined by the sheath (32), relative to the handpiece (20), through a handle (34). Such rotation can provide rotation of the end effector (40) and the rod (30) in isolation. In some other versions, the gripper (34) is intended to rotate the end effector (40) without rotating any portion of the rod (30) which is in a position proximal to the hinge section (36). As another merely illustrative example, the electrosurgical instrument (10) may include a rotation control that provides rotation capability of the rod (30) and the end effector (40) as a single unit; and another rotation control that provides the ability to rotate the effector (40) without rotating any portion of the rod (30) that is proximal to the hinge section (36). Other suitable rotation schemes will become apparent to persons skilled in the art in view of the teachings of the present invention. Logically, rotating elements can simply be omitted if desired. B. Exemplary end effector
    [00032] The end effector (40) of the present example comprises a first claw (42) and a second claw (44). In the present example, the second claw (44) is substantially fixed relative to the rod (30); while the first claw (42) rotates relative to the rod (30) towards and away from the second claw (42). In some versions, actuators such as rods or cables, etc., can extend through the sheath (32) and can be joined with the first jaw (42) in a pivotal coupling (43) so that the longitudinal movement of the rods/ cables/etc. Actuators through the rod (30) provide rotation of the first jaw (42) with respect to the rod (30) and with respect to the second jaw (44). Of course, the claws (42, 44) can instead have any other suitable type of movement and can be activated in any other suitable way. Just as an example, and as will be described in more detail below, the claws (42, 44) can be activated and thus closed by the longitudinal translation of a firing beam (60), so that the rods/cables/ etc. actuators can simply be eliminated in some versions.
    [00033] As best seen in figures 2 to 4, the first claw (42) defines an elongated slit that extends longitudinally (46); while the second claw (44) also defines an elongated longitudinally extending slit (48). In addition, the upper side of the first claw (42) has a first electrode surface (50); while the underside of the second claw (44) has a second electrode surface (52). The electrode surfaces (50, 52) are in communication with an electrical source (80) through one or more conductors (not shown) that extend along the length of the rod (30). The electrical source (80) is intended to provide RF energy to the first electrode surface (50) at a first polarity and to a second electrode surface (52) at a second (opposite) polarity, so that the RF current flow between the electrode surfaces (50, 52) and so through the tissue captured between the claws (42, 44). In some versions, the firing beam (60) serves as an electrical conductor that cooperates with the electrode surfaces (50, 52) (eg as a return to ground) to release bipolar RF energy captured between the grips ( 42, 44). The electrical source (80) may be external to the electrosurgical instrument (10) or may be integral with the electrosurgical instrument (10) (eg, the handpiece (20), etc.), as described in one or more references cited in the present invention or otherwise. A controller (82) regulates the release of energy from the electrical source (80) to the electrode surfaces (50, 52). The controller (82) may also be external to the electrosurgical instrument (10) or may be integral with the electrosurgical instrument (10) (eg, the handpiece (20), etc.) as described in one or more cited references in the present invention or otherwise. It should also be understood that electrode surfaces (50, 52) can be provided in a variety of locations, configurations, and alternative relationships.
    [00034] As best seen in Figure 4, the underside of the first claw (42) includes a longitudinally extending recess (58) adjacent to the slot (46); while the upper side of the second claw (44) includes a longitudinally extending recess (58) adjacent to the slot (48). Figure 2 shows the upper side of the first claw (42) including a plurality of serrated teeth (46). It should be understood that the underside of the second claw (44) may include complementary sawings that fit with the sawings (46) to improve the grip of tissue captured between the claws (42, 44) without necessarily tearing the tissue. Figure 3 shows an example of sawing (46) in the first claw (42) mainly as recesses; with serrated (48) in the second claw (44) mainly as protrusions. Logically, sawings (46, 48) can take any other suitable form or can simply be omitted altogether. It should also be understood that the sawings (46, 48) may be formed of an electrically non-conductive or insulating material, such as plastic, glass and/or ceramic, for example, and may include a treatment such as polytetrafluoro ethylene, a lubricant, or some other treatment to substantially prevent tissue from becoming immobilized in the jaws (42, 44).
    [00035] With the claws (42, 44) in a closed position, the rod (30) and the end effector (40) are sized and configured to fit through trocars that have various internal diameters, so that the instrument electrosurgical (10) is usable in minimally invasive surgery, although, of course, the electrosurgical instrument (10) can also be used in open procedures, if desired. By way of example only, with the jaws (42, 44) in a closed position, the rod (30) and end effector (40) may have an outside diameter of approximately 5 mm. Alternatively, the rod (30) and the end effector (40) may have any other suitable outside diameter (e.g. between approximately 2 mm and approximately 20 mm, etc.).
    [00036] As another merely illustrative variation, either claw (42, 44) or both claws (42, 44) can include at least one door, passage, conduit, and/or other element that is intended to extract steam from the 'water, smoke, and/or other gases/vapours/etc. of the surgical site. Such an element may be in communication with a source of suction, such as an external source or a source within the handpiece (20), etc. In addition, the end effector (40) may include one or more tissue cooling elements (not shown) that reduce the degree or extent of thermal scatter caused by the end effector (40) on adjacent tissue when the surfaces of electrode (50, 52) are activated. Various suitable forms such cooling elements may take will become apparent to persons skilled in the art in view of the teachings of the present invention.
    [00037] In some versions, the end effector (40) includes one or more sensors (not shown) that are configured to detect a variety of parameters in the end effector (40), including but not limited to tissue temperature. adjacent tissue, electrical resistance or impedance of the adjacent tissue, tension across the adjacent tissue, forces exerted on the claws (42, 44) by the adjacent tissue, etc. By way of example only, the end effector (40) may include one or more positive coefficient temperature (PTC) thermistor bodies (54, 56) (eg PTC polymer, etc.) located adjacent to the electrodes (50, 52) and/or elsewhere. Data from the sensors can be transmitted to the controller (82). Controller (82) can process such data in a variety of ways. By way of example only, the controller (82) may modulate or otherwise alter the RF energy being delivered to the electrode surfaces (50, 52), based at least in part on data acquired from one or more sensors in the end effector (40). Additionally or alternatively, the controller (82) may alert the user to one or more conditions through an audio and/or visual feedback device (e.g., speaker, lights, screen, etc.), based, at least in part, on data acquired from one or more sensors in the end effector (40). It should also be understood that some types of sensors do not necessarily need to be in communication with the controller (82), and may simply provide a purely localized effect at the end effector (40). For example, PTC thermistor bodies (54, 56) in the end effector (40) can automatically reduce the energy release on the electrode surfaces (50, 52) depending on the temperature of the tissue and/or the end effector (40 ) increases, thus reducing the likelihood of overheating. In some such versions, a thermistor element with PTC is in series with the power supply (80) and the electrode surface (50, 52); and the PTC thermistor provides increased impedance (reducing current flow) in response to temperatures that exceed a threshold. In addition, it should be understood that electrode surfaces (50, 52) can be used as sensors (eg to detect tissue impedance, etc.). Various types of sensors that may be incorporated into the electrosurgical instrument (10) will become apparent to persons skilled in the art in view of the teachings of the present invention. Similarly, various things that can be done with data from the sensors, by the controller (82) or otherwise, will become apparent to those skilled in the art in view of the teachings of the present invention. Other suitable variations for the end effector (40) will also be apparent to those skilled in the art in view of the teachings of the present invention. C. Exemplary shooting beam
    [00038] As can also be seen in figures 2 to 4, the electrosurgical instrument (10) of the present example includes a firing beam (60) that is longitudinally movable along part of the length of the end effector (40). The firing beam (60) is positioned coaxially within the rod (30), extends along the length of the rod (30), and translates longitudinally within the rod (30) (including the hinge section (36) herein. example), although it should be understood that the firing beam (60) and the rod (30) may have any other suitable relationship. The firing beam (60) includes a sharpened distal blade (64), an upper flange (62), and a lower flange (66). As best seen in Figure 4, the distal blade (64) extends through the slots (46, 48) of the claws (42, 44), with the upper flange (62) being located above the claw (44) in the recess (59) and the lower flange (66) being located below the jaw (42) in the recess (58). The configuration of the distal blade (64) and flanges (62, 66) provide an "I-beam" type of cross section at the distal end of the firing beam (60). Although the flanges (62, 66) extend longitudinally only over a small portion of the length of the firing beam (60) in the present example, it should be understood that the flanges (62, 66) may extend longitudinally along any suitable length of firing beam (60). Furthermore, although the flanges (62, 66) are positioned along the outside of the jaws (42, 44), the flanges (62, 66) may alternatively be disposed in corresponding slots formed within the jaws (42, 44). For example, each claw (42, 44) may define a "T" shaped slit, with distal blade portions (64) being disposed in a vertical portion of each T shaped slit and with the flanges (62 , 66) being arranged in the horizontal portions of the "T" shaped slots. Various other suitable configurations and relationships will become apparent to those skilled in the art in view of the teachings of the present invention.
    [00039] The distal blade (64) is substantially sharp, so that the distal blade easily cuts tissue that is captured between the claws (42, 44). The distal blade (64) is also electrically grounded in this example, providing a return path for the RF energy, as described elsewhere in this document. In some other versions, the distal blade (64) serves as an active electrode. Additionally or alternatively, the distal blade (64) can be selectively energized with ultrasonic energy (eg harmonic vibrations at approximately 55.5 kHz, etc.).
    [00040] Trigger beam (60) "I-beam" configuration type provides closure of the jaws (42, 44) as the trigger beam (60) is advanced distally. In particular, the flange (62) drives the claw (44) pivotally towards the claw (42) while the firing beam (60) is advanced from a proximal position (figures 1-3) to a distal position (figure 4), when rolling against the recesses (59) formed in the claw (44). This closing effect on the claws (42, 44) made by the firing beam (60) can occur before the distal blade (64) reaches the tissue captured between the claws (42, 44). Such staging of the contacts by the firing beam (60) can reduce the gripping force of the handle (24) needed to activate the firing beam (60) through a full firing stroke. In other words, in some such versions, the firing beam (60) may already have overcome an initial resistance required to substantially close the claws (42, 44) on the tissue before encountering resistance from the tissue captured between the claws (42 , 44). Logically, any other suitable staging can be provided.
    [00041] In the present example, the flange (62) is configured to cam against an inclined element at the proximal end of the claw (44) to open the claw (42) when the firing beam (60) is retracted to a proximal position and to keep the claw (42) open when the firing beam (60) remains in the proximal position. This caming capability can facilitate the use of the end effector (40) to separate tissue layers, to perform blind dissections, etc., by forcing the claws (42, 44) away from a closed position. In some other versions, the claws (42, 44) are resiliently pulled into an open position by a spring or other type of resilient element. Although the claws (42, 44) close or open while the firing beam (60) is translated in the present example, it should be understood that other versions may provide independent movement of the claws (42, 44) and firing beam (60 ). By way of example only, one or more cables, rods, beams, or other elements may extend through the rod (30) to selectively activate the grippers (42, 44) independently of the firing beam (60). Such gripper activating elements (42, 44) can be separately controlled by a dedicated handpiece element (20). Alternatively, such gripper activating elements can be controlled by the trigger (24) in addition to causing the trigger (24) to control the firing beam (60). It should also be understood that the firing beam (60) can be resiliently pulled to a proximal position so that the firing beam (60) retracts proximally when a user relaxes their grip on the actuator (24). D. Exemplary operation
    [00042] In an exemplary use, the extremity effector (40) is inserted into a patient through a trocar. The pivot section (36) is substantially straight when the end effector (40) and stem portion (30) are inserted through the trocar. The pivot control (28) can then be manipulated to revolve or flex the pivot section (36) of the rod (30) so as to position the end effector (40) in a desired position and orientation in relation. to an anatomical structure within the patient. Two layers of tissue from the anatomical structure are then captured between the claws (42, 44) by pressing the trigger (24) towards the pistol grip (22). Such tissue layers may be part of the same natural lumen that defines the anatomical structure (eg, blood vessel, portion of the gastrointestinal tract, portion of the reproductive system, etc.) in a patient. For example, one layer of tissue may comprise the upper portion of a blood vessel while the other layer of tissue may comprise the lower portion of the blood vessel, along the same length region of the blood vessel (e.g. that the trajectory of the fluid through the blood vessel before using the electrosurgical instrument (10) is perpendicular to the longitudinal axis defined by the extremity effector (40), etc.). In other words, the lengths of the claws (42, 44) can be oriented perpendicularly (or at least generally transversely) to the length of the blood vessel. As noted above, the flanges (62, 66) act in a cam fashion to rotate the claw (42) toward the claw (44) when the firing beam (60) is actuated distally by pressing the actuator (24) toward to the pistol grip (22).
    [00043] With the tissue layers captured between the claws (42, 44), the firing beam (60) continues to advance distally by the user pressing the trigger (24) towards the pistol grip (22). As the firing beam (60) advances distally, the distal blade (64) simultaneously cuts the attached tissue layers, resulting in separate portions of the topsheet being placed in apposition with respective separate portions of the underlayer. In some versions, this results in a blood vessel being cut in a direction that is generally transverse to the length of the blood vessel. It should be understood that the presence of flanges (62, 66) immediately above and below the jaws (42, 44), respectively, can help to keep the jaws (42, 44) in a closed and tight clamping position. In particular, the flanges (62, 66) can help maintain a significantly compressive force between the jaws (42, 44). With the cut tissue layer portions being compressed between the grips (42, 44), the electrode surfaces (50, 52) are activated with bipolar RF energy by the user pressing the activation button (26). In some versions, the electrodes (50, 52) are selectively coupled with the power supply (80) (eg by the user pressing the button (26), etc.) so that the electrode surfaces (50) , 52) of the claws (42, 44) are activated with a first common polarity while the firing beam (60) is activated with a second polarity that is opposite to the first polarity. In this way, a bipolar RF current flows between the firing beam (60) and the electrode surfaces (50, 52) of the claws (42, 44), through the compacted regions of cut portions of the tissue layer. In some other versions, the electrode surface (50) has one polarity while the electrode surface (52) and firing beam (60) both have the other polarity. In any version (among at least a few others), the bipolar RF energy released by the power supply (80) essentially thermally welds the portions of the tissue layer on one side of the firing beam (60) together and the portions of the fire layer. fabric on the other side of the firing beam (60) together.
    [00044] In certain circumstances, heat generated by activated electrode surfaces (50, 52) can denature the collagen within portions of the tissue layer and, in cooperation with the pinch pressure provided by the claws (42, 44), the denatured collagen can form a seal within portions of the tissue layer. In this way, the cut ends of the natural lumen that define the anatomical structure are hemostatically sealed so that no body fluids leak out of the cut ends. In some versions, the electrode surfaces (50, 52) can be activated with bipolar RF energy before the firing beam (60) even starts to translate distally and thus before the tissue is even cut. For example, such timing can be provided in versions in which the button (26) serves as a mechanical lock in relation to the actuator (24) in addition to serving as a switch between the power source (80) and the electrode surfaces (50, 52).
    [00045] Although several of the teachings below are described as variations of the electrosurgical instrument (10), it should be understood that several teachings below can also be incorporated into various other types of devices. Just as an example, in addition to being easily incorporated into the electrosurgical instrument (10), various teachings below can be easily incorporated into the devices taught in any of the references cited here, other types of electrosurgical devices, surgical staplers, applicators of surgical clips, and tissue claws, among various other devices. Other suitable devices into which the following teachings may be incorporated will become apparent to those skilled in the art in view of the teachings of the present invention. II. Exemplary articulation joint configurations
    [00046] As noted above, some versions of the stem (30) include a hinge section (36), which is intended to selectively position the end effector (40) at various angles to the longitudinal axis defined by the sheath (32) . The various examples of shapes that the hinge section (36) and the other components of the stem (30) can take will be described in more detail below, while additional examples will become apparent to those skilled in the art in view of the teachings of the present invention. By way of example only, some alternative examples merely illustrative of the articulation section (36) are presented in US patent application No. [Attorney Precedent No. END6889USNP1], entitled "Articulation Joint Features for Articulating Surgical Device," filed at same date of the present application, the description of which is incorporated herein by reference. A. Exemplary articulation section with parallel support rails
    [00047] Figures 5 and 6 show an exemplary articulation section (100) disposed between a rigid rod section (102) and an end effector (104). It should be understood that these elements can be easily incorporated into the electrosurgical instrument (10) described above, with the rod section (102) corresponding to the rod (30) and the end effector (104) corresponding to the end effector (40) . The hinge section (100) of this example comprises a molded element (110) defining a plurality of slots (112, 114, 116) and a pair of recesses (118). The molded element (110) can comprise a variety of materials, including, but not limited to Vectra, Isoplast, a high density polyethylene, and/or various other materials. In some cases, the material that forms the molded element (110) provides a resilient pull for the molded element (110) to assume a substantially straight orientation. Other suitable selections and properties for molded element (110) will become apparent to elements skilled in the art in view of the teachings of the present invention. Similarly, although molded element (110) is formed through a molding process in the present example, it should be understood that a variety of other processes can be used, including, but not limited to extrusion, etc.
    [00048] The slits (112, 114) extend longitudinally along the length of the molded element (110), opening in an upper portion of the molded element (110), but ending within the lower portion of the molded element (110). The slot (112) extends along the axis of the molded element (110) while the slots (114) are laterally spaced from the axis. The slots (116) are oriented transverse to the axis of the molded element (110). Like the slots (112, 114), the slots (116) also open in an upper portion of the molding element (110) while terminating within the lower portion of the molding element (110). The slots (116) are configured to facilitate flexing of the molded element (110). The slit (112) is configured to slidingly receive the firing beam (160). The firing beam (160) is equivalent to the firing beam (60) discussed above. Therefore, it should be understood that the firing beam (160) is intended to translate longitudinally within the slit (112). It should also be understood that the firing beam (160) has sufficient flexibility to allow the firing beam to translate along a curved path when the hinge section is in an inclined hinged configuration. The material that forms the molded element (110) and/or the coatings on the molded element (110) can be selected to minimize friction between the firing beam (160) and the molded element (110). By way of example only, molding element 110 may include baked on silicone and/or sodium stearate and/or various other materials.
    [00049] The recesses (118) are configured to receive hinge bands (140, 142). The distal ends of the hinge bands (140, 142) are secured to the distal end of the hinge section (100). The proximal ends of the hinge bands (140, 142) are in communication with a control such as the hinge control (28). In some versions, the pivot control (28) is intended to selectively advance or retract one band (140, 142) while keeping the position of the other band (140, 142) substantially constant, thus making the pivot section (100) flex. In some other versions, the articulation control (28) is intended to selectively advance the strip (140) while simultaneously retracting the strip (142); and/or selectively retracting the swath (140) while simultaneously advancing the swath (142). Logically, the strips (140, 142) can be replaced by cables and/or various other types of components. A flexible sheath or shell can be positioned around the hinge section (100) to help secure the straps (140, 142) against the molded element (110). Additionally or alternatively, the molded element (110) may include slits and/or other types of vertically extending elements that hold the strips (140, 142) against the molded element (110), including when the hinge section (100 ) is in a slanted configuration.
    [00050] The slots (114) are configured to receive spring bundles (150). In some versions, the spring bundles (150) are resiliently tensioned to orient the molded element (110) in a substantially straight configuration. This resilient traction can also reduce bonding loads on the firing beam (160) when the firing beam (160) translates through the hinge section (100) in an inclined configuration. The spring bundles (150) are also configured to enhance the structural integrity of the hinge section (100), such as by providing resistance to bending or lateral bursting of the firing beam (160) when the firing beam (160) translates through the hinge section (100) in an inclined configuration. Since the spring bundles (150) are located in slots (114) that are separate from the slot (112) for the firing beam (160), the spring bundles (150) do not come into contact with the firing beam (160) during the operation of the hinge section (100) and/or during the operation of the firing beam (160). This spacing can also reduce the pinch loads of the spring bundles (150) on the firing bundle (160).
    [00051] In some versions, both ends of each spring bundle (150) are loose, so that the spring bundles (150) float freely within the hinge section (100). In some other versions, one end of each spring bundle (150) is secured relative to the hinge section (100) while the other end of each spring bundle (150) floats free. Other suitable components, configurations, arrangements, and relationships will become apparent to those skilled in the art in view of the teachings of the present invention. It should also be understood that any of the slots (112, 114, 116) and/or some other component of the hinge section (110) can accommodate one or more wires that provide electrical communication between the end effector (104) and a source feed. B. Exemplary articulation section formed by molded joint
    [00052] Figures 7 to 9 show another exemplary articulation section (200) disposed between a rigid rod section (202) and an end effector (204). It should be understood that these elements can be easily incorporated into the electrosurgical instrument (10) described above, with the rod section (202) corresponding to the rod (30) and the end effector (204) corresponding to the end effector (40) . The hinge section (200) of this example comprises a molded element (210) that defines a plurality of slots (212, 216), a lumen (214) and a pair of recesses (218). The molded element (210) can comprise a variety of materials, including, but not limited to Vectra, Isoplast, a high density polyethylene, and/or various other materials. In some cases, the material that forms the molded element (210) provides a resilient pull for the molded element (210) to assume a substantially straight orientation. Other suitable selections and properties for molded element (210) will become apparent to elements skilled in the art in view of the teachings of the present invention. Similarly, although molded element (210) is formed through a molding process in the present example, it should be understood that a variety of other processes can be used.
    [00053] As best seen in figures 8 to 9, the slit (212) and the lumen (214) each extend longitudinally along the length of the molded element (110). The slot (212) is configured to accommodate one or more wires that provide electrical communication between the end effector (204) and a power source. The lumen (214) is configured to slidingly receive a firing beam (not shown), much like the slit (112) that receives the firing beam (160), as described above. In this way, a firing beam can translate through the molded element (210) regardless of whether the hinge section (200) is in a substantially straight or slanted configuration. The slots (216) are oriented transverse to the axis of the molded element (210). The slots (216) are configured to facilitate flexing of the molded element (210). In the present examples, as best seen in Figure 9, the slots (216) are alternately misaligned in their relative spacing along the length of the molded element (210). Such a configuration can facilitate flexing of the molded element (210). In some other versions, the slots (216) are positioned oppositely rather than being misaligned.
    [00054] The recesses (218) are configured to receive hinge bands (240, 242). The distal ends of the hinge bands (240, 242) are attached to the distal end of the hinge section (200). The proximal ends of the hinge bands (240, 242) are in communication with a control such as the hinge control (28). In some versions, the pivot control (28) is intended to selectively advance or retract one band (240, 242) while keeping the position of the other band (240, 242) substantially constant, thus making the pivot section (200) flex. In some other versions, the pivot control (28) is intended to selectively advance the strip (240) while simultaneously retracting the strip (242); and/or selectively retract the swath (240) while simultaneously advancing the swath (242). As yet another merely illustrative example, the pivot control (28) may be intended to selectively advance the strap (240) while letting the strap (242) remain slack/free; and/or selectively retract the band (240) while letting the band (242) remain slack/free. Of course, the strips (240, 242) can be replaced by cables and/or various other types of components; and they can work in many other ways.
    [00055] A flexible sheath or sheath can be positioned around the hinge section (200) to help secure the straps (240, 242) against the molded element (210). Additionally or alternatively, the molded element (210) may include slits and/or other types of vertically extending elements that hold the strips (240, 242) against the molded element (210), including when the hinge section (200 ) is in a slanted configuration.
    [00056] Figures 10 to 11 show another exemplary articulation section (300) disposed between a rigid rod section (302) and an end effector (304). It should be understood that these elements can be easily incorporated into the electrosurgical instrument (10) described above, with the rod section (302) corresponding to the rod (30) and the end effector (304) corresponding to the end effector (40). The hinge section (300) of this example comprises a pair of molded elements (310, 311). Each molded element (310, 311) can comprise a variety of materials, including, but not limited to Vectra, Isoplast, a high density polyethylene, and/or various other materials. In some cases, the material that forms the molded elements (310, 311) provides a resilient pull for the molded elements (310, 311) to assume a substantially straight orientation. Other suitable selections and properties for molded elements (310, 311) will become apparent to elements skilled in the art in view of the teachings of the present invention. Similarly, although the molded elements (310, 311) are formed through a molding process in the present example, it should be understood that a variety of other processes can be used. The molded elements (310, 311) are configured to be joined in apposition to form the hinge section (300) as shown in Figure 10. The molded elements (310, 311) can be secured together in various ways, including, but not limited to, not limited to adhesives, ultrasonic welding, pressure mounting, claws, clips, an outer sheath, etc.
    [00057] As best seen in Figure 11, the molded element (310) includes a plurality of recesses (312, 314, 316, 318) and a plurality of ribs (320). The recesses (312, 314, 316, 318) extend longitudinally along the length of the molded element (310). The recess (312) is positioned on an upper side of the molded element (310) while the recesses (314, 316, 318) are positioned on an underside of the molded element (310). The ribs (320) extend laterally from the molded element (310) and are equidistantly spaced along the length of the molded element. The recess (312) is configured to accommodate one or more wires that provide electrical communication between the end effector (304) and a power source.
    [00058] The molded element (311) also includes a plurality of recesses (313, 315, 317, 319) and a plurality of ribs (321). The recesses (313, 315, 317, 319) extend longitudinally along the length of the molded element (311). The recess (313) is positioned on an upper side of the molding element (311) while the recesses (315, 317, 319) are positioned on an underside of the molding element (311). The ribs (321) extend laterally from the molded element (310) and are equidistantly spaced along the length of the molded element. The recess (313) is configured to accommodate one or more wires that provide electrical communication between the end effector (304) and a power source. In some versions, the recess (312) or recess (313) receives such a wire, while the other recesses (312, 313) do not receive a wire. In some other versions, each recess (312, 313) receives at least one respective wire.
    [00059] When the molded elements (310, 311) are joined as shown in Figure 10, the recesses (314, 315) align and cooperate to form a channel through which a firing beam (not shown) can be disposed of. sliding way. This channel is thus functionally similar to the lumen (214) described above. Furthermore, the recesses (316, 317) align and cooperate to form a channel to receive a first pivot cable (not shown) while the recesses (318, 319) align and cooperate to form a channel to receive a second cable. of hinge (not shown) when the molded elements (310, 311) are joined. Such hinge cables can function in a similar manner to that described above for the hinge bands (140, 142). In some other versions, the recesses (316, 317, 318, 319) are configured to form channels that receive bands rather than cables. Other suitable elements that can be used to provide articulation of the hinge section (300) will become apparent to elements of skill in the art in view of the teachings of the present invention. As best seen in Figure 10, the ribs (320, 321) are configured to intermesh with each other when the molded elements (310, 311) are joined. However, it should be understood that the ribs (320, 321) may instead align with each other if desired. It should also be understood that the ribs (320, 321) allow the hinge section (300) to flex with respect to its longitudinal axis regardless of whether the ribs (320, 321) are aligned or interspersed. In some versions, an outer shell or retractable tube is provided on the outside of the molded elements (310, 311), although this is merely optional. Such a casing or tube can help secure the molded elements (310, 311) together.
    [00060] Figures 12 to 13 show yet another exemplary hinge section (400) which is essentially a variation of the hinge section (300) described above. The pivot section (400) is formed by a pair of abutment molded elements (410, 411). Each molded element (410, 411) can comprise a variety of materials, including, but not limited to Vectra, Isoplast, a high density polyethylene, and/or various other materials. In some cases, the material forming the molded elements (410, 411) has resilient properties and thus induces the molded elements (410, 411) to assume a substantially straight orientation. In other words, the molded elements (410, 411) may have shape memory, providing a bias towards a substantially straight configuration. Other suitable selections and properties for molded elements (410, 411) will become apparent to elements skilled in the art in view of the teachings of the present invention. Similarly, although the molded elements (410, 411) are formed through a molding process in the present example, it should be understood that a variety of other processes can be used.
    [00061] The molded element (410) also includes a plurality of recesses (414, 416, 418) and a plurality of ribs (420). The recesses (414, 416, 418) are essentially equivalent to the recesses (314, 316, 318) described above, so they will not be described in greater detail here. It should also be understood that molding element (410) may include a recess that is analogous to recess (312) described above. Similarly, the molding element (411) includes a plurality of recesses (415, 417, 419) and a plurality of ribs (421), with the recesses (415, 417, 419) being essentially equivalent to the recesses (315 , 317, 319) described above. The molded element (411) may also include a recess that is analogous to the recess (313) described above.
    [00062] Unlike the molded element (310), the molded element (410) includes a plurality of columns (430) extending downwardly from the underside of the molded element (410). The ribs (420) of the molded element (410) also include a plurality of recesses (422). Unlike molding element (311), molding element (411) includes a plurality of openings (431) that are configured to receive posts (430) when molding elements (410, 411) are joined. The ribs (421) of the molded element (411) include a plurality of protrusions (423), which are received in the recesses (422) of the corresponding ribs (420) of the molded element (410) when the molded elements (410, 411) ) are joined. In this way, unlike the ribs (320, 321) of the molded elements (310, 311), the ribs (420, 421) line up with one another when the molded elements (410, 411) are joined.
    [00063] Figure 13 illustrates another difference between molded elements (410, 411) and molded elements (310, 311). In particular, Figure 13 shows how the thickness of a spine section (440) of the molded elements (410, 411) reduces along the length of the hinge section (400). It should be understood that the left side of figure 13 corresponds to the distal end of the hinge section (400) while the right side of figure 13 corresponds to the proximal end of the hinge section (400). As shown, a proximal region (442) of the spine section (440) has a width "W1" that is more than the width "W2" of a distal region (444) of the spine section (440). Such a configuration can reduce the amount of force required to bend the distal end of the hinge section (400) relative to the longitudinal axis defined by the hinge section (400). In other words, gradually reducing the width of the spine section (440) along the length of the hinge section (400) can facilitate the articulation of the hinge section (400). Logically, any other elements or other suitable settings can be used. In some versions, an outer shell or retractable tube is provided on the outside of the molded elements (410, 411), although this is merely optional. Such a casing or tube can help secure the molded elements (410, 411) together. C. Articulation section with exemplifying accounts
    [00064] Figures 14 to 20 show yet another exemplary articulation section (500) that is disposed between a rigid rod section (502) and an end effector (504). As will be described in more detail below, the end effector (504) is coupled with a rotation section (580), which is positioned distal to the hinge section (500). It should be understood that these elements can be easily incorporated into the electrosurgical instrument (10) described above, with the rod section (502) corresponding to the rod (30) and the end effector (504) corresponding to the end effector (40). However, as will be described in more detail below, in some versions the end effector (504) is rotatable with respect to the stem section (502) and with respect to the pivot section (500). The hinge section (500) of this example comprises a plurality of coaxially aligned beads (510). As best seen in Figures 15 through 16, each bead (510) includes a first face (512) and a second face (514). Each face (512, 514) has a convex configuration. With the beads (510) positioned adjacent to each other, the convex configuration of the faces (512, 514) can facilitate the articulation of the hinge section (520). For example, the face (512) of a bead (510) may simply roll against the face (514) of an adjacent bead (510) during pivoting.
    [00065] The outer perimeter of each bead (510) also includes recesses (520, 522, 524) extending from the face (512) to the face (514). The beads (510) are all similarly configured in this example so that corresponding recesses (520, 522, 524) of adjacent beads (510) can be easily aligned with one another. As shown in Figures 14 and 18 to 20, the recesses (520, 522) receive the respective pivot cables (540, 542). The hinge cables (540, 542) may function in a manner similar to that described above for the hinge bands (140, 142). Of course, cables (540, 542) can be replaced by tracks and/or various other types of structures. The recess (524) is configured to receive a wire (544) as shown in Figure 20. As will be described in more detail below, the wire (544) is configured to provide electrical communication between the end effector (504) and a power supply. It should be understood that, as with other wires referred to herein, wire (544) can easily flex with pivot section (500) when pivot section (500) is pivoted.
    [00066] Each bead (510) further includes a center hole (530) extending from the face (512) to the face (514). All holes (530) of all beads (510) are substantially coaxially aligned when the hinge section (500) is in a substantially straight configuration. As best seen in Figure 17, a trigger cable (560) extends through the holes (530). The lead wire (560) of the present example comprises a multi-tape construction with sufficient tensile strength to withstand the distal and proximal driving forces through the lead wire (560). The construction of the lead wire (560) also allows it (560) to be used to pivotally drive the end effector (504) in any direction, as will be described in more detail below. As can also be seen in Figure 17, each hole (530) has a tapered configuration, which can facilitate the flexing of the conductor cable (560) through the hinge section (500) when the hinge section (500) is in a configuration. articulated. The holes (530) are also sized to allow rotation of the lead wire (560) within the beads (510), as will be described in more detail below. In some versions, an outer shell or retractable tube is provided over the outside of the beads (510), although this is merely optional. Such a casing or tube can help secure the beads (510) together.
    [00067] The lead wire (560) is secured to a trigger bar (562) through an adapter (561) in a region distal to the pivot section (500). The fire bar (562) is essentially equivalent to the fire bar (60) described above. In particular, the trigger bar (562) includes a distal blade (564) and a pair of flanges (566) that are configured to close the jaws (506, 508) when the trigger bar (562) is advanced distally; and to open the claws (506, 508) when the trigger bar (562) is proximally retracted. The lead wire (560) is intended to drive the trigger bar (562) distally and proximally by translating the lead wire (560) distally or proximally. The lead wire (560) can be translated by driving the driver (24) and/or in any other suitable way.
    [00068] Other components, elements, configurations, and operating capabilities suitable for the hinge sections described above (100, 200, 300, 400, 500) will become apparent to elements of skill in the art in view of the teachings of the present invention. III. Exemplary Articulation Control Settings
    [00069] The articulation control (28) can take a variety of forms. By way of example only, the articulation control (28) may be configured in accordance with one or more teachings of US Patent Application No. [Attorney Precedent No. END6888USNP], entitled "Control Features for Articulating Surgical Device," filed on the same date as the present application, the description of which is incorporated herein by reference. As another merely illustrative example, the articulation control (28) may be configured in accordance with one or more teachings of US patent application No. [Attorney Precedent No. END6888USNP1], entitled "Control Features for Articulating Surgical Device," filed on the same date as the present application, the description of which is incorporated herein by reference. Furthermore, the hinge section can be configured in accordance with the teachings of at least one other reference cited here. Various other suitable forms that pivot control (28) can take will become apparent to those skilled in the art in view of the teachings of the present invention. IV. Other Exemplary Elements
    [00070] It should be understood that any of the versions of the electrosurgical instrument (10) described herein may include various other elements in addition to or instead of those described above. By way of example only, Figures 14 and 17 to 20 show an example of a distal rotation section (580) that can be used to provide rotational capability of the end effector (504) in a region that is distal to the end section. articulation (500). In other words, the rotation section (580) and the end effector (504) can be rotated together while the pivot section (500) and the rod section (502) remain substantially stationary. It should be understood that the pivot section (580) and the end effector (504) can be pivoted together regardless of whether the pivot section (500) is in a substantially straight configuration or in an inclined/hinged configuration.
    [00071] In the present example, the rotation section (580) and the end effector (504) are rotated by the rotation of the conductor cable (560). For example, in some versions, the handpiece (20) includes a gripper or other element for the purpose of rotating the conductor cable (560). In some other versions, the handpiece (20) is omitted, and the rotating section (580) and end effector (504) are driven by the motor, solenoid, and/or some other element as part of a system. robotic. Other components, configurations, and techniques suitable for actuating the rotation system and end effector (504) will become apparent to those skilled in the art in view of the teachings of the present invention. It should also be understood that an electrosurgical instrument (10) can provide two forms of rotation. For example, one form of rotation may include simultaneous rotation of the rod section (502), pivot section (500), pivot section (580), and end effector (504) (regardless of whether the pivot section ( 500) is in a straight or slanted configuration); while another form of rotation may include rotation of just the rotation section (580) and the end effector (504), with the rod section (502) and the pivot section (500) remaining rotationally stationary (again regardless of whether the pivot section (500) is in a straight or slanted configuration).
    [00072] As noted above, wire (544) passes through the pivot section (500) to provide electrical communication between the end effector (504) and a power source that is proximal to the stem (502). In the present example, the rotation section (580) is configured to allow electrical energy to be transmitted from the wire (544) to the end effector (504) without the wire (544) catching or twisting when the end effector ( 504) is rotated relative to the pivot section (500). In particular, and as best seen in Figures 19 to 20, the wire (544) is secured to an extension (584) of a slip ring (586). The slip ring (586) is positioned and resiliently tensioned to contact a clamp (590), which includes distally extending arms (594). The extension (584), the slip ring (586), the clamp (590), and the extending arms (594) each comprise an electrically conductive material. All these components are contained within a wrap (582). The arms (594) are in electrical communication with one or both of the grips (506, 508) to provide bipolar RF energy through one or both of the grips (506, 508), as described above and as described in several references which are cited in the present invention.
    [00073] The clamp (590) is attached to a body (592) within the rotation section (580). The clamp (590) and body (592) rotate together with the end effector (504). The relationship between the slip ring (586) and the clamp (590) provides electrical continuity between the slip ring (586) and the clamp (590) even when the clamp (590) rotates with the end effector (504) while the slip ring (586) and pivot section (500) remain rotationally stationary. It should be understood that one or more support surfaces or elements may also be provided between the pivot section (500) and the pivot section (580) to further facilitate the rotation of the pivot section (580) relative to the hinge section (580).
    [00074] Although the example shown in figures 14 and 17 to 20 is provided in the context of the pivot section (500), it should be understood that the rotation section (580) can also be easily incorporated into any of the others. versions of articulating sections of the electrosurgical instrument (10) described here. It is also to be understood that the rotation section (580) may also be readily incorporated into various other types of instruments, including, but not limited to, the various types of instruments that are described in the present invention and/or that are described in the various references. which are cited in the present invention. Still other suitable instruments in which the rotation section (580) may be incorporated will become apparent to those skilled in the art in view of the teachings of the present invention.
    [00075] It should be understood that any of the devices of the present invention may also include one or more of the various elements presented in US patent application No. [Attorney Precedent No. END6888USNP], entitled "Control Features for Articulating Surgical Device," filed on the same date as the present application, the description of which is incorporated herein by reference; U.S. Patent Application No. [Attorney Precedent No. END6888USNP1], entitled "Articulation Joint Features for Articulating Surgical Device," filed on the same date as the present application, the description of which is incorporated herein by reference; and/or U.S. Patent Application No. [Attorney Precedent No. END6889USNP1], entitled "Control Features for Articulating Surgical Device," filed on the same date as the present application, the description of which is incorporated herein by reference.
    [00076] It is also to be understood that any of the devices described herein may be modified to include a motor or other device with electrical propulsion to drive a component that is otherwise manually moved. Several examples of these modifications are described in U.S. Patent Application No. 13/151,481 entitled "Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback," filed June 2, 2011, the description of which is incorporated herein by reference. Various other suitable ways in which a motor or other electrically propelled device can be incorporated into any of the devices of the present invention will become apparent to those skilled in the art in view of the teachings of the present invention.
    [00077] Furthermore, it should be understood that any of the devices described herein can be modified to contain most, if not all, of the necessary components within the medical device itself. More specifically, the devices described here can be adapted to use an internal or pluggable power supply rather than requiring the device to be plugged into an external power source by a cable. Several examples of how medical devices can be adapted to include a portable power supply are presented in US Provisional Application Serial No. 61/410,603, filed November 5, 2010, entitled "Energy-Based Surgical Instruments," which is described in this document. incorporated herein by reference. Various other suitable ways in which a power supply can be incorporated into any of the devices of the present invention will become apparent to persons skilled in the art in view of the teachings of the present invention. SAW. Other components
    [00078] Although the examples of the present invention are described primarily in the context of electrosurgical instruments, it should be understood that the teachings of the present invention can be readily applied to a variety of other types of medical instruments. By way of example only, the teachings of the present invention can be readily applied to tissue grippers, tissue access pouch implantation instruments, surgical staplers, ultrasonic surgical instruments, etc. It should also be understood that the teachings of the present invention can be readily applied to any of the instruments described in any of the references cited in the present invention, so that the teachings of the present invention can be easily combined with the teachings of any of the references. cited in the present invention in various ways. Other types of instruments into which the teachings of the present invention can be incorporated will be apparent to those skilled in the art.
    [00079] It is understood that any patent, publication, or other descriptive material, in whole or in part, which is said to be incorporated into the present invention by way of reference, is incorporated into the present invention only if the incorporated material does not enter. in conflict with existing definitions, statements, or other descriptive material presented in this description. Accordingly, and to the extent necessary, the description as explicitly stated herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, which is hereby incorporated by reference into the present invention, but which conflicts with existing definitions, statements, or other descriptive materials set forth herein will be incorporated herein only to the extent that no conflict. will appear between the embodied material and the existing descriptive material.
    [00080] Modalities of the present invention have application in endoscopic and conventional open surgical instrumentation, as well as application in robotic-assisted surgery. For example, those skilled in the art will recognize that the various teachings of the present invention can be easily combined with the various teachings of US Patent No. 6,783,524 entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument," issued August 31, 2004, the description of which is incorporated herein by reference.
    [00081] Modalities of the devices described here can also be designed to be discarded after a single use, or to be used multiple times. Modalities can, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps of disassembling the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, device modalities can be disassembled, in any number of particular pieces or device parts can be selectively replaced or removed in any combination. With cleaning and/or replacement of particular parts, device modalities can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those of skill in the art will understand that reconditioning a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. The use of such techniques, and the resulting refurbished device, are all within the scope of this patent application.
    [00082] By way of example only, the modalities described here can be processed prior to surgery. First, a new or used instrument can be obtained, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or high energy electrons. Radiation can kill bacteria in the instrument and in the container. The sterilized instrument can then be stored in a sterile container. The sealed container can keep the instrument sterile until opened at the medical facility. The device may also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide, or water vapor.
    [00083] In view of the presentation and description of various embodiments of the present invention, further adaptations of the methods and systems described in this document can be made through appropriate modifications made by an expert in the art, without departing from the scope of the present invention. Several potential modifications have been mentioned and others will be evident to those skilled in the art. For example, the examples, modalities, geometry, materials, dimensions, proportions, steps, and the like discussed above are illustrative only and are not required. Accordingly, the scope of the present invention is to be considered in accordance with the terms of the following claims and it is understood that it is not limited to the details of structure and operation shown and described in the specification and drawings.
    权利要求:
    Claims (14)
    [0001]
    1. Electrosurgical device, which comprises: (a) a body; (b) an end effector comprising: (i) a first claw, wherein the first claw includes a first electrode, and (ii) a second claw, wherein the second claw includes a second electrode, wherein the first claw is movable towards the second claw to grip tissue between the first and second claws, the first and second electrodes being intended to supply RF energy to tissue trapped between the first and second claws; (c) a rod extending between the body and the end effector, where the rod defines a longitudinal axis, where the rod includes a hinge section, where the hinge section is intended to selectively position the effector of end in non-parallel positions in relation to the longitudinal axis of the shank, and characterized by the fact that the flexible cutting element having a sharp distal blade which is intended to cut the tissue trapped between the first claw and the second claw, and in which the hinge section comprises a flexible molded plastic piece having a longitudinal recess, wherein a portion of the cutting element is disposed in the longitudinal recess for longitudinal movement therein.
    [0002]
    2. Electrosurgical device according to claim 1, characterized in that the articulation section comprises a pair of complementary pieces of flexible molded plastic, placed together.
    [0003]
    3. Electrosurgical device according to claim 2, characterized in that it also comprises a resilient beam disposed in another recess of the molded plastic part.
    [0004]
    4. Electrosurgical device according to claim 3, characterized in that the resilient beam is parallel to the portion of the cutting element disposed in the longitudinal recesses.
    [0005]
    5. Electrosurgical device according to claim 1, characterized in that the joint section comprises one or more joint beams that are intended to selectively drive the end effector towards, or away from, the longitudinal axis of the rod to thus articulate the end effector.
    [0006]
    6. Electrosurgical device according to claim 1, characterized in that the molded plastic part has a plurality of lateral recesses separating a plurality of laterally extending ribs positioned on two lateral sides of the articulation section, in which the ribs positioned on a first lateral side of the hinge section are spaced longitudinally from ribs positioned on a second lateral side of the hinge section.
    [0007]
    7. Electrosurgical device according to claim 1, characterized in that the molded plastic part defines a recess configured to receive a wire to supply electrical energy to the end effector.
    [0008]
    8. Electrosurgical device according to claim 2, characterized in that the molded plastic parts have a plurality of lateral recesses separating a plurality of laterally extending ribs positioned on two lateral sides of the articulation section, in which a the first set of ribs is also positioned on the upper half of the hinge section, wherein a second set of ribs is positioned on a lower half of the hinge section, wherein the first set of ribs is interspersed with the second set of ribs.
    [0009]
    9. Electrosurgical device according to claim 2, characterized in that the molded plastic parts have a plurality of lateral recesses separating a plurality of laterally extending ribs positioned on two lateral sides of the articulation section, in which the The hinge section further includes spine portions separating the two lateral sides of the hinge section, wherein a proximal spine portion has a first width at a proximal region of the hinge section, wherein a distal spine portion has a second width at a distal region of the hinge section.
    [0010]
    10. Electrosurgical device according to claim 9, characterized in that the second width is smaller than the first width.
    [0011]
    11. Electrosurgical device according to claim 10, characterized in that the width of the spine portions successively reduces after each pair of ribs from a proximal pair of ribs to a pair of distal ribs.
    [0012]
    12. Electrosurgical device according to claim 1, characterized in that the articulation section includes an external retractable tube.
    [0013]
    13. Electrosurgical device according to claim 1, characterized in that the rod further comprises a rotation section, in which the rotation section is distal to the articulation section, in which the rotation section is intended to rotate the end effector in relation to the articulation section.
    [0014]
    14. Electrosurgical device according to claim 1, characterized in that the body comprises a handpiece.
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    公开号 | 公开日
    WO2012040445A1|2012-03-29|
    JP2013543393A|2013-12-05|
    JP2013540004A|2013-10-31|
    AU2011305403A1|2013-03-14|
    RU2013118683A|2014-10-27|
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    BR112013006517A2|2016-07-12|
    RU2581713C2|2016-04-20|
    CA2811298C|2019-12-24|
    EP2618763B1|2015-09-16|
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    AU2011305410A1|2013-03-14|
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    RU2013118585A|2014-10-27|
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    BR112013006969B1|2021-08-10|
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    KR20130137175A|2013-12-16|
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    CA2811298A1|2012-03-29|
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    JP5878175B2|2016-03-08|
    JP5937079B2|2016-06-22|
    US20120078247A1|2012-03-29|
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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]|
    2019-12-17| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2021-06-22| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-08-10| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 22/09/2011, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US38611710P| true| 2010-09-24|2010-09-24|
    US61/386,117|2010-09-24|
    PCT/US2011/052723|WO2012040438A1|2010-09-24|2011-09-22|Articulation joint features for articulating surgical device|
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