SURGICAL INSTRUMENT

专利摘要:
surgical instruments with lockable articulated end actuator. the present invention relates to manual surgical instruments that have an end actuator attached to an elongated stem. the end actuator has at least a portion that is movable in response to opening and closing movements applied to it by a closing member. an articulation control system is provided to articulate the end actuator in relation to the stem. an articulation locking system is provided to lock the end actuator in a desired articulated position. the locking system interfaces with the closing member and is activated by applying a closing movement to the end actuator.
公开号:BR112013023731B1
申请号:R112013023731-7
申请日:2012-03-13
公开日:2021-04-27
发明作者:John C. Schuckmann；Jeffrey S. Swayze；Charles J. Scheib
申请人:Ethicon Endo-Surgery, Inc；
IPC主号:

专利说明:

Background Technical Field
[0001] The present invention relates to surgical instruments and, in various modalities, to minimally invasive surgical instruments that have an articulated end actuator. Background
[0002] Endoscopic and other minimally invasive surgical instruments typically include an end actuator positioned at the distal end of an elongated stem and a cable at the proximal end of the elongated stem, which allows a physician to manipulate the end actuator. In use, the end actuator is delivered to a surgical site through a trocar cannula. At the surgical site, the end actuator engages the tissue in a number of ways to achieve a diagnostic or therapeutic effect. Endoscopic surgical instruments are often preferred over traditional open surgical instruments, due to the fact that they require smaller incisions, which are usually cured with less postoperative recovery time than traditional open surgical incisions. Because of this and other benefits of endoscopic surgery, there has been significant development in a range of endoscopic surgical instruments with end actuators that engage tissue to perform various surgical tasks. For example, end actuators have been developed to act as endoscopic surgical instruments, grippers, cutters, staplers, clamp applicators, access devices, drug / gene therapy delivery devices, ultrasound, laser or RF energy devices and others cirurgical instruments.
[0003] In use, the positioning of the end actuator at the surgical site can be restricted by the trocar cannula. In general, the elongated stem of the device allows the clinician to insert the end actuator to a desired depth and rotate the end actuator about the longitudinal geometric axis of the stem. This allows the end actuator to be positioned at the surgical site, to a certain degree. With careful placement of the trocar and the use of handles, for example, through another trocar, this level of positioning is often sufficient. However, depending on the nature of the operation, it may be desirable to adjust the position of the end actuator of an endoscopic surgical instrument. In particular, it is often desirable to orient the end actuator at any one of the multiple angles with respect to the longitudinal geometric axis of the instrument's elongated stem.
[0004] The movement of the end actuator through multiple angles in relation to the instrument stem is conventionally called "articulation". The articulation is typically performed by a pivot joint (or articulation) that is placed on the elongated stem near the end actuator. This allows the clinician to remotely articulate the end actuator, to one side or the other, for better surgical placement of tissue fixators and easier manipulation and tissue orientation. An articulated end actuator allows the doctor to more easily engage tissue in some cases, such as behind an organ. In addition, the articulated positioning advantageously allows an endoscope to be positioned behind the end actuator, without being blocked by the elongated stem.
[0005] Approaches to articulated end actuators tend to be complicated due to the fact that the mechanisms, to control the joint, need to be integrated with the mechanisms to operate the end actuator. For example, for end actuators that have claw features with the ability to open and close, the closing sleeve, the drive member and the articulation mechanisms need to be implemented within the constraints of the small diameter of the instrument stem. A previous common design involves an articulated accordion-shaped mechanism ("flexible neck") that is articulated through the selective extraction of one of the two connecting rods through the implement rod, with each rod being displaced respectively on opposite sides of the line center of the stem. The connecting rods engage in the form of a ratchet through a series of different positions.
[0006] Over the years, other forms of articulated end actuator arrangements have been developed. For example, US patent No. 7,670,334, entitled "Surgical Instrument Having an Articulating End Effector", and US patent No. 7,819,298, entitled "Surgical Stapling Apparatus With Control Features Operable With One Hand", the descriptions of which are incorporated herein, by reference in their respective totalities, describe various surgical instruments that employ the articulated end actuator provisions that effectively address many of the disadvantages of previous instruments with articulated actuators.
[0007] Many prior surgical instrument arrangements also employ a component commonly referred to as a "mouthpiece" that is swiveled on the instrument handle and is attached to the elongated stem. When the physician wishes to rotate the end actuator about the geometric axis of the stem, he simply rotates the nozzle with respect to the cable. When the doctor also wants to articulate the end actuator, the doctor needs to actuate a sliding bar or other form of joint control member, to achieve the desired joint. Such control devices (for example, the mouthpiece and the bar / joint control arrangement) typically need to be actuated through the use of both hands.
[0008] When performing many surgical procedures, it is desirable to perform a desired amount of articulation and rotation of the end actuator through the use of just one hand. For example, many vascular operations require precise control of the end actuator. In such applications, it would be desirable to be able to have a surgical instrument that employs a single control mechanism to articulate and selectively rotate the end actuator, which can be easily actuated through the use of the same hand that is supporting the instrument's cable portion.
[0009] The aforementioned discussion is only intended to illustrate some of the disadvantages present in the field of the invention at the moment, and should not be taken as a denial of the scope of the claims. summary
[00010] According to the general aspects of at least one shape, a surgical instrument is provided that has an elongated shaft that defines a longitudinal geometric axis. An end actuator is coupled to the elongated stem for selective pivoting displacement in this regard. The end actuator has at least one movable portion that is responsive to opening and closing movements. A closing member interfaces with the movable portion of the end actuator to selectively apply the closing movement to it. An articulation control system interfaces operationally with the end actuator to apply articulation movements to it. A joint locking system interfaces with the joint control system and said closing member. The hinge lock system is configured to move from an unlocked position, where the hinge control system applies hinge movements to the end actuator, and a locked position, where the hinge lock system prevents the articulation control system apply the articulation movements to the end actuator by applying the closing movement by the closing member.
[00011] According to other general aspects of at least one shape, a surgical instrument is provided that has an elongated shaft that defines a longitudinal geometric axis. An end actuator is coupled to the elongated stem for selective pivoting displacement in relation to this for various articulated positions. The end actuator has at least one portion that is mobile responsive to opening and closing movements. A closing member interfaces with the movable portion of the end actuator to apply the closing movement to this when the closing member is moved in a closing direction. In addition, the closing member applies the opening movement to the movable portion of the end actuator when the closing member is moved in an opening direction. A first elongated pivot member is movably supported relative to the closing member and is configured to apply a first pivot movement to the end actuator when the first elongated pivot member is moved in a first actuating direction, and a second pivot movement to the end actuator when the first pivot member is moved in a second actuating direction. A locking member operationally interfaces with the closing member and the first elongated hinge member, so that when the closing member is moved in the closing direction, the locking member lockably engages the first elongated pivot member to prevent movement in the first and second actuating directions, and when the closing member is moved in the opening direction, the locking member disengages the first pivot member to allow the first pivot member to move move in the first and second direction of action.
[00012] In accordance with other general aspects of at least one form, a method for operating a surgical instrument is presented. In various forms, the method comprises providing a surgical instrument that has an end actuator, which has at least a portion that is mobile responsive to opening and closing movements applied to it. The end actuator is also pivotable about a longitudinal geometric axis for a plurality of articulated positions, in response to articulation movements applied to it. The method additionally comprises applying an articulating motion to the end actuator to articulate the end actuator to one of the articulated positions and applying a closing motion to the end actuator so that, by applying the closing motion, the actuator edge is retained in the hinged position. Brief Description of Drawings
[00013] The characteristics mentioned above and other characteristics and advantages of this invention, and the way of obtaining them, will become more apparent and the invention itself will be better understood by reference to the following description of modalities of the invention, taken in conjunction with the attached drawings, in which:
[00014] Figure 1 is a perspective view of a surgical instrument with a non-limiting joint end actuator modality of a form of the present invention;
[00015] Figure 2 is an exploded view of a non-limiting hinge end actuator modality of at least one form of the present invention;
[00016] Figure 3 is an overall view of a non-limiting embodiment of the joint control system of at least one form of the present invention;
[00017] Figure 4 is a perspective view of the non-limiting joint control system of Figure 3;
[00018] Figure 5 is a perspective view of a portion of the non-limiting joint control system of Figures 3 and 4;
[00019] Figure 6 is a perspective view of the non-limiting joint control system of Figures 3 to 5, with a portion thereof shown in cross section;
[00020] Figure 7 is a plan view in cross section of the non-limiting articulation control system of Figures 3 to 6, with the end actuator articulated in a first articulation direction;
[00021] Figure 8 is another plan view in cross section of the non-limiting articulation control system of Figures 3 to 7, with the end actuator in a non-articulated orientation;
[00022] Figure 9 is another plan view in cross section of the non-limiting articulation control system of Figures 3 to 8, with the end actuator articulated in a second articulation direction;
[00023] Figure 10 is a perspective view of a non-limiting joint control system modality of at least one other form of the present invention;
[00024] Figure 11 is a perspective view of the non-limiting joint control system of Figure 10, with the rotation nozzle omitted for clarity;
[00025] Figure 12 is a perspective view of the non-limiting joint control system of Figures 10 and 11, with some components shown in cross section;
[00026] Figure 13 is an exploded view of the non-limiting joint control system of Figures 10 to 12;
[00027] Figure 14 is a plan view in cross section of the non-limiting articulation control system of Figures 10 to 13, with the end actuator articulated in a first articulation direction;
[00028] Figure 15 is another plan view in cross section of the non-limiting joint control system of Figures 10 to 14, with the end actuator in a non-articulated orientation;
[00029] Figure 16 is another plan view in cross section of the non-limiting articulation control system of Figures 10 to 15, with the end actuator articulated in a second articulation direction;
[00030] Figure 17 is a perspective view of a non-limiting joint control system modality of at least one other form of the present invention;
[00031] Figure 18 is another perspective view of the non-limiting joint control system of Figure 17, with some components shown in cross section;
[00032] Figure 19 is an exploded view of the non-limiting joint control system of Figures 17 and 18, with some components shown in cross section;
[00033] Figure 20 is another exploded view of the non-limiting joint control system of Figures 17 to 19, with some components shown in cross section;
[00034] Figure 21 is a perspective view of the non-limiting joint control system of Figures 17 to 20, with the right nozzle portion moved in the first actuation direction;
[00035] Figure 22 is a plan view in cross section of the non-limiting articulation control system of Figures 17 to 21, with the end actuator articulated in a first articulation direction;
[00036] Figure 23 is another plan view in cross section of the non-limiting articulation control system of Figures 17 to 22, with the end actuator articulated in a second articulation direction;
[00037] Figure 24 is a perspective view of a non-limiting nozzle assembly embodiment of another form of the present invention;
[00038] Figure 25 is a cross-sectional view of the mouthpiece assembly of Figure 24, taken along line 25-25 in Figure 24;
[00039] Figure 26 is a perspective view of a non-limiting joint control system modality of at least one other form of the present invention;
[00040] Figure 27 is a perspective view of a portion of the non-limiting joint control system modality of Figure 26;
[00041] Figure 28 is another perspective view of the portion of the non-limiting joint control system modality of Figure 27, with a portion shown in cross section;
[00042] Figure 29 is an exploded view of the non-limiting joint control system of Figures 26 to 28;
[00043] Figure 30 is a side elevation view of a portion of the non-limiting joint control system of Figures 26 to 29;
[00044] Figure 31 is a plan view in cross section of the non-limiting articulation control system of Figures 26 to 30, with the end actuator articulated in a first articulation direction;
[00045] Figure 32 is another plan view in cross section of the non-limiting joint control system of Figures 26 to 31, with the end actuator in a non-articulated orientation;
[00046] Figure 33 is another plan view in cross section of the non-limiting articulation control system of Figures 26 to 32, with the end actuator articulated in a second articulation direction;
[00047] Figure 34 is a perspective view of a non-limiting joint control system modality of at least one other form of the present invention;
[00048] Figure 35 is a perspective view of a portion of the non-limiting joint control system modality of Figure 34;
[00049] Figure 36 is a rear perspective view of the modality of the non-limiting joint control system of Figures 34 and 35;
[00050] Figure 37 is a perspective view in cross section of the modality of the non-limiting joint control system of Figures 34 to 36;
[00051] Figure 38 is an exploded view of the modality of the non-limiting joint control system of Figures 34 to 37;
[00052] Figure 39 is a cross-sectional view of the modality of the non-limiting joint control system of Figures 34 to 38;
[00053] Figure 40 is another cross-sectional view of the non-limiting articulation control system of Figures 34 to 39, with the end actuator articulated in a first articulation direction;
[00054] Figure 41 is another cross-sectional view of the modality of the non-limiting joint control system of Figures 34 to 40;
[00055] Figure 42 is a cross-sectional view of the modality of the non-limiting articulation control system of Figures 34 to 41, with the end actuator articulated in a second articulation direction;
[00056] Figure 43 is a perspective view of another embodiment of the non-limiting joint control system of the present invention;
[00057] Figure 44 is an exploded view of the modality of the non-limiting joint control system of Figure 43;
[00058] Figure 45 is another exploded view of the modality of the non-limiting joint control system of Figures 43 and 44;
[00059] Figure 46 is another exploded view of the non-limiting joint control system of Figures 43 to 45;
[00060] Figure 47 is a cross-sectional view of the modality of the non-limiting joint control system of Figures 43 to 46, in an unlocked position;
[00061] Figure 48 is an enlarged cross-sectional view of a portion of the modality of the non-limiting joint control system of Figures 43 to 47, in an unlocked position;
[00062] Figure 49 is a cross-sectional view of the modality of the non-limiting joint control system of Figures 43 to 48, in a locked position; and
[00063] Figure 50 is an enlarged cross-sectional view of a portion of the modality of the non-limiting joint control system of Figures 43 to 49, in a locked position. Detailed Description
[00064] The applicant for this application also holds ownership of US patent application Serial No., entitled "SURGICAL INSTRUMENTS WITH TRAVELABLE END-USER", Summary No. END6846USNP / 100531, which was filed on the same date as this and it is incorporated herein by reference, in its entirety.
[00065] Certain exemplary modalities will now be described to provide a general understanding of the principles of structure, function, manufacture and use of the instruments and methods described here. One or more examples of these modalities are illustrated in the attached drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are exemplary non-limiting modalities, and that the scope of the various modalities of the present invention is defined only by the claims. The reference, from the beginning to the end of the specification, of "several modalities", "some modalities", "a modality", or "the modality", or similar, means that an attribute, structure, or characteristic described together with the modality, is included in at least one modality. Therefore, the appearance of the phrases "in various modalities", "in some modalities", "in one modality", or "in the modality", or similar, in places from beginning to end of the specification, are not necessarily all referring to to the same modality. In addition, the particular attributes, structures, or characteristics can be combined in any suitable way in one or more modalities. Therefore, the particular attributes, structures, or characteristics illustrated or described in conjunction with a modality can be combined, in whole or in part, with the structures of the attributes, or characteristics of one or more other modalities without limitation. Such modifications and variations should be included in the scope of the various modalities of the invention presented in the present invention and their respective equivalents.
[00066] The terms "proximal" and "distal" are used in the present invention with reference to a physician's manipulation of the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the physician, and the term "distal" refers to the portion located farthest from the clinician. It will be further understood that, for convenience and clarity, spatial terms such as "vertical", "horizontal", "up", "down", "right" and "left" can be used in the present invention in relation to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.
[00067] Various instruments and exemplifying methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, those of ordinary skill in the art will readily understand that the various methods and instruments presented in the present invention can be used in numerous surgical procedures and applications including, for example, in connection with "open" surgical procedures. With the advancement of this Detailed Description, those with common knowledge of the technique will additionally appreciate that the various instruments presented here can be inserted into a body in any way, such as through a natural orifice, through an incision or perforation formed in tissue , etc. The functional portions or portions of the instrument end actuator can be inserted directly into a patient's body or can be inserted through an access device that has a working channel, through which the end actuator and the elongated stem of a surgical instrument can be advanced.
[00068] Returning now to the drawings, in which the reference numbers denote similar components from all the different views, Figure 1 presents a modality of a surgical stapling and separation instrument 10 that is capable of putting into practice the various exclusive benefits of at least one form of the present invention. Several portions of the instrument 10 may be identical to the portions of the devices disclosed in US Patent No. 7,670,334, which has been incorporated herein, by reference and / or US Patent No. 7,000,818, entitled "Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems ", whose report is hereby incorporated by reference in its entirety.
[00069] As shown in Figure 1, in a non-limiting manner, the surgical instrument 10 generally includes a handle 12, a stem 14 and an articulation end actuator 20, which is pivotally connected to the stem 14 on the articulation pivot 16. An articulation control 200 is provided to rotate the end actuator 20 around the pivot pivot 16. The end actuator 20 is shown configured to act as an end cutter to pinch, separate and staple the fabric. However, those skilled in the art will understand that various embodiments of the present invention may include end actuators (not shown) that are configured to act like other surgical devices including, for example, grippers, cutters, staplers, staple applicators, access, drug / gene therapy delivery devices, ultrasound, RF, or laser energy devices, etc.
[00070] The cable 12 of the instrument 10 can include a closing trigger 30 and a trigger trigger 40 to actuate the end actuator 20. It will be recognized that the instruments that have end actuators directed to different surgical tasks, can have numbers or different types of triggers or other controls suitable for operating an end actuator. The end actuator 20 is shown separated from a cable 12 by the elongated stem 14 which defines a longitudinal geometric axis A-A. A physician can articulate end actuator 20 in relation to stem 14 around a hinge axis BB which is substantially transversal to the longitudinal axis AA (hinge pivot 16) using hinge control 200, as will be discussed in detail additional information below. As used herein, the expression, "substantially transversal to the longitudinal geometric axis" where the "longitudinal geometric axis" is the geometric axis of the rod 14, refers to a direction that is almost perpendicular to the longitudinal geometric axis. It will be understood, however, that the directions that deviate a little from the perpendicular to the longitudinal geometric axis, are also substantially transversal to the longitudinal geometric axis.
[00071] Figure 2 shows an exploded view of the end actuator 20 and the elongated stem 14, including various internal components. An end actuator frame 90 and a stem frame 100 are configured to be joined at the hinge pivot 50, which defines a hinge axis B-B (FIG. 1). The stem frame 100 is supported by the cable 12 in a known manner. As such, the construction of the stem frame 100 will not be discussed in more detail here, in addition to what is necessary to understand the various embodiments of the present invention. In various embodiments, for example, the end actuator frame 90 has a protrusion 96 integrally formed or otherwise attached to it, which is coupled to a distally directed terminal 102 on the stem frame 100, defining an opening 104. Opening 104 can be positioned to interface with a pivot pin (not shown) included in the frame of the end actuator 90, which allows the frame of the end actuator 90 to pivot in relation to the frame of the stem 100 and, consequently, that the end actuator 20 pivot in relation to the stem 14. When assembled, the various components can pivot around the pivot pivot 50 on the pivot geometric axis BB as shown in Figure 1.
[00072] As can be seen further in Figure 2, in a non-limiting form, the end actuator 20 includes an elongated channel 110 which is dimensioned and configured to removably support a staple cartridge 120 there. The elongated channel 110 is attached to the frame of the end actuator 90 by a pair of tabs of the frame 93, which extend in corresponding grooves 115 in the elongated channel 110. The staple cartridge 120 may comprise a molded cartridge body 122 that supports operationally a plurality of clamps 124, which rest on the corresponding clamp actuators 126 within respective upwardly opened clamp openings 128. In this non-limiting embodiment, the end actuator 20 also includes a fixed claw 130 which is coupled to the elongated channel 110. A pair of openings 112 can be provided in the elongated channel 110 to movably receive rotating pins or pins 132 in the fixed jaw 130, which allows the fixed jaw 120 to pivot from an open position to a closed position in relation to to the elongated channel 110 and the staple cartridge 120, in response to opening and closing movements received from a closing tube assembly 140. Such movements Clamping elements can also be used to effectively actuate the grips of other types of end actuators, as is known.
[00073] As can also be seen in Figure 2, the closure tube assembly 140 employs a "double pivot" closure sleeve assembly 142. It will be understood that the invention is not limited to a pivot closure sleeve design double and can include any suitable closing sleeve arrangement. In various non-limiting embodiments, for example, the double pivot closure sleeve assembly 142 includes a proximal closure tube segment 141 that has upper and lower terminals 146, 148 that project distally. An end actuator closing tube section 150 includes a horseshoe-shaped opening 152 and a flap 154 for engaging an opening flap 134 on the fixed jaw 130. As is known, when the end actuator closing tube section 150 is advanced distally in the frame of the end actuator 90, the horseshoe-shaped opening applies a closing movement to the flap 134 to move the fixed claw 130 towards the clamp cartridge 120. When the end actuator closing tube 150 it is extracted in the proximal direction, the flap 154 engages the flap 134 to move the fixed jaw 130 in the direction away from the staple cartridge 120 to an open position. The section of the closing tube 150 is shown, which has upper terminals 156 and lower (not visible), which project proximally.
[00074] The end actuator closing tube section 150 is pivotally attached to the proximal closing tube segment section 141 by an upper double pivot connection 160 and a lower double pivot connection 170. The upper connection of double pivot 160 includes distal and proximal pivot pins projecting upward 162, 164, which engage, respectively, an upper pin hole 157 in the upper terminal that projects proximally 156 and an upper proximal pin hole 147 in the upper terminal that protrudes distally 146. A double double pivot connection 170 includes proximal and distal pivot pins projecting downward (not shown) that engage, respectively, a lower distal pin hole in the proximally protruding lower terminal and a lower proximal pin 149 in the lower terminal projecting distally 148. In use, the closing sleeve assembly 140 is translated distally to close the fixed claw 130, for example, in response to the actuation of the closing trigger 30.
[00075] The device 10 additionally includes a firing bar 180 which is configured to travel longitudinally through the axis 14, through the flexible closure and the pivot frame articulation joint 50 and through a firing groove 91 in the firing frame. end actuator 90 on end actuator 20. The firing bar 180 may be constructed of a solid section or, in various embodiments, may include a laminated material comprising, for example, a stack of steel plates 182. It will be understood that a firing bar 180, produced from a laminated material, can decrease the force required to articulate the end actuator 20. An end protruding distally from the firing bar 180 is fixed to a beam at E 184, which helps in spacing of the fixed jaw 130 of the staple cartridge 120 when the fixed jaw 130 is in a closed position. A sharp cutting edge 186 of the E 184 beam can also be used to separate the fabric.
[00076] In operation, the beam at E 184 acts on the staple cartridge 120. A wedge plank 190 is driven distally by the beam at E 184, which slides over a cartridge tray 192 that contains the various components of the replaceable staple cartridge 120. The wedge plank 192 moves the clamp conductors 126 upwards by cam to force the clamps 124 outward for deformation contact with the fixed claw 130, while a cutting surface 186 of the E-beam 184 separates the fabric pinned. The firing bar 180 is movably supported within the rod 14, so that it passes through the cartridge 120 when the instrument 10 is fired (for example, actuated). In at least one non-limiting embodiment, the firing bar 180 is instead positioned within the rod 14, so that all or a portion of the body of the firing bar element 180 is supported by a groove (not shown) on the fixed grapple 130 during firing. Due to the fact that the fixed jaw 130 can be stronger than the cartridge 120, the groove holder can prevent the firing bar 180 from bending, even when high loads are applied to the distal end of the firing bar 180. This can be useful in embodiments where the firing bar element 182 includes laminated plates 182.
[00077] Various beam configurations also include upper pins 188, which are configured to engage fixed jaw 130 during firing, while middle pins 185 and lower base 187, engage various portions of cartridge body 122, cartridge tray 192 and elongated channel 110. In use, a centrally arranged groove 123 in the cartridge body 122, aligns with a groove 193 in the cartridge tray 190 and with a groove 113 in the elongated channel 110. The front edge of the E beam 184 slides through of the aligned grooves 123, 193 and 113. As the firing bar 180 is advanced distally, the base 187 is held against the bottom of the channel 110 and the upper pins 180 are kept in a groove 131 on the lower surface of the fixed claw 130, for prevent the fixed jaw 130 and channel 110 from being forced to separate due to the resistance of the fabric. Thereafter, the firing bar 180 is retracted proximally, also retracting the beam at E 184, which allows the fixed claw 130 to be opened to release the two stapled and separated tissue portions (not shown).
[00078] In various non-limiting modalities, a spring clip 195 is mounted on the frame of the end actuator 90 as a lock for the firing bar 180. The square, distal and proximal openings 192, 193, formed at the top of the frame of the end actuator 90, can define a clamp bar 196 between them, which receives an upper arm 197 from a clamp spring 195 whose distally extended lower arm 198 confers a downward force on an elevated portion 183 of the firing bar 180, as is known. It will be understood that various modalities may include other types of locks or none at all.
[00079] In the various modalities shown in Figures 1 and 3 to 9, the end actuator 20 is selectively rotatable about the longitudinal geometric axis AA and selectively articulated around the geometric axis of BB, in relation to the proximal stem segment 141 by the articulation control system 200. In various non-limiting modalities, the articulation control system 200 includes a nozzle 210 that is rotatably supported in relation to the cable 12. In the modalities shown in Figures 3 to 9, the nozzle 210 has a portion proximal end 212 tapering to a distal end portion 214. To facilitate easy rotation of the nozzle 210 around the longitudinal geometric axis AA by a portion of the same hand in which the physician is holding the handle 12, a plurality of buttons radially projecting actuators 216 are formed around the proximal end 212 of the nozzle 210 as shown. The doctor can then rotate the nozzle 210 in relation to the handle with his index finger or another finger or portion of his hand that is supporting the handle 12.
[00080] Returning to Figures 3 and 4, it can be noted that the nozzle 210 can be supplied in multiple parts for assembly purposes. In the illustrated embodiment, for example, the nozzle 210 is formed from a lower nozzle portion 211 and an upper nozzle portion 213. The lower and upper nozzle portions 211, 213 can be manufactured, for example, from polycarbonate with glass filler or other suitable material, and be interconnected to each other by adhesive, welding, pressure fitting features, screws, suitable friction rods / holes, etc. In various non-limiting embodiments, the nozzle 210 is pivotally attached to the proximal closing tube segment 141 by the lower and upper pins 220, 222, respectively. The proximal closing tube segment 141 can be manufactured in multiple segments for mounting purposes. Those skilled in the art will understand that the proximal portion of the proximal closing tube segment 141 will interface with known components for fixing or communicating with the device's closing trigger. For example, such provisions are disclosed in US patent No. 7,000,818, which has been incorporated by reference. However, the performance of the closing tube assembly can be controlled by a range of other known trigger and cable arrangements, without departing from the spirit and scope of the present invention. In the embodiment shown in Figures 3 to 6, the proximal closing tube segment 141 is manufactured from a lower shank segment 143 and an upper shank segment 145. In various embodiments, the upper and lower shank segments 143, 145 they can be manufactured from stainless steel or other suitable material, and can be connected to each other by a suitable adhesive or other suitable fixation arrangement to form a substantially hollow tubular structure, to accommodate the various components of the articulation control system 200 , such as an articulation assembly 230 as well as the firing bar 182, stem frame 100, etc.
[00081] As can be seen in Figures 3 and 6, in various non-limiting modalities, the upper pin 220 is received rotatably within an orifice 149 in the upper stem segment 145 and the lower pin 222 is received rotatably in a lower orifice 147 in the lower stem segment 143. The lower and upper pins 220, 222 are coaxially aligned and define a nozzle geometrical axis CC around which the nozzle 210 can pivot in relation to the proximal closing tube segment 141. As may be more particularly seen in Figure 6, an orifice 219 is provided through the proximal end 214 of the nozzle 210. Orifice 219 is dimensioned in relation to the proximal closing tube segment 141, to allow the nozzle 210 to be pivoted around the geometric axis of DC nozzle, as will be discussed in further detail below.
[00082] In the non-limiting embodiment of Figure 2, the hinge control system 200 includes a hinge assembly 230. In at least one embodiment, the hinge assembly 230 may comprise a right hinge rod 232 and a left hinge rod 234. Left and right hinge rods 232, 234 can be configured as shown in Figures 2 and 3, and can be manufactured from stainless steel or other suitable material. The pivot assembly 230 comprises a right pivot rod 232 and a left pivot rod 234 which, when received within the proximal closing tube segment 141, can be axially moved there relative to one another, as will be discussed in further detail. bellow. As can be seen in Figure 2, the left and right pivot rods 232, 234 define a centrally arranged elongated groove 236 that is configured to accommodate the axial movement of the firing bar 180 between them. A right pivot band 238 protrudes distally from a distal end 233 of the right pivot rod 232 and a left pivot band 240 projects distally from the distal end 239 of the left pivot rod 234. See Figure 2. In various non-limiting embodiments, the pivot strips 238, 240 are attached to the projection 96. For example, the strips 238, 240 can be pivotally attached to the projection 96.
[00083] The articulation assembly 230 is configured to interface with the nozzle 210, so that the pivoting path of the nozzle 210 around the geometric axis of the nozzle CC results in the axial actuation of the left and right articulation rods 232, 234 which finally, they make the end actuator 20 articulate around the geometric axis of articulation BB. More specifically and with reference to Figures 3, 5 and 6 to 9, the right pivot rod 232 has a right pivot pin 250 that is attached to it and projects laterally from it through a right groove 251 in the pipe segment proximal closure 141. The end of the right pivot pin 250 extends into a socket or right opening 252 in the nozzle 210. Similarly, the left pivot rod 234 has a left pivot pin 254 that is attached to it and it projects laterally from it through a left groove 255 in the proximal closing tube segment 141. The end of the left pivot pin 254 extends into a socket or opening 256 in the nozzle 210.
[00084] The operation of the articulation control system 200 can be understood from the reference to Figures 7 to 9. Figure 7 illustrates the articulation of the end actuator 20 to the left of the articulation pivot 50 (around the geometric axis joint joint - shown in Figure 1). To perform this joint range, the doctor pivots the nozzle 210 in the first actuation direction, represented by the arrow "E" in Figure 7. When the nozzle 210 is pivoted in the "E" direction, the right articulation rod 232 is moved in the distal direction "DD" and the left articulation rod 234 is moved in the proximal direction "PD". Such movement of the left and right articulation rods 232, 234 results in the application of a thrust movement of the projection 96 by the right articulation band 238 and a pulling movement towards the projection 96 by the left articulation band 240, which results in the articulation end actuator 20 as shown. Figure 8 illustrates the end actuator 20 in coaxial alignment with the stem 14 (for example, in a non-hinged position). Such an end actuator orientation can be employed, for example, during insertion of the end actuator 20 through a trocar cannula (not shown) or other opening, into the patient. Figure 9 illustrates the articulation of the end actuator 20 to the right of the articulation pivot 50 (around the geometric axis of articulation B-B - shown in Figure 1). To achieve this joint range, the doctor pivots the nozzle 210 in the second actuation direction, represented by the arrow "F" in Figure 9. When the nozzle 210 is pivoted in the "F" direction, the right articulation rod 232 is moved in the proximal direction "PD" and the left articulation rod 234 is moved in the distal direction "DD". Such movement of the left and right articulation rods 232, 234 results in the application of an impulse movement to the projection 96 by the left articulation band 240, and in a movement of pull to the projection 96 by the right articulation band 238, resulting in the articulation of the end actuator 20 as shown. The end actuator 20 can be rotated around the longitudinal axis simply by rotating the nozzle 210 around the longitudinal axis A-A. This action can be performed by a portion of the hand that is supporting the cable portion of the device, thus avoiding the need for both hands to rotate the end actuator around the longitudinal geometric axis. Although the hinge assembly 230, as described above, employs two elongated rods or hinge members, in alternative embodiments, only one elongated hinge member is employed.
[00085] Figures 10 to 17 illustrate another embodiment of the non-limiting joint control system of the present invention, generally designated as 300, which is similar to the joint control system 200 described above, except for the differences noted below. These components, which are the same components used in the modalities described above, will be marked with the same element numbers and the elements versed in the technique can refer to the description presented earlier in this document that explains their construction and operation. As can be seen in Figure 10, the articulation control system 300 employs a separate rotation nozzle 302 to control the rotation (arrow "G" in Figure 10) of the closing tube assembly 140 and, finally, the end 12. As can be seen in Figure 13, in at least one embodiment, the rotation nozzle 302 is manufactured from an upper portion of rotation nozzle 303 and a lower portion of rotation nozzle 304, which is attached to the portion top of rotation nozzle 303, for example, by columns and friction sockets 341, 343. However, the nozzle portions 303, 304 can be fixed by other suitable means such as adhesive, welding, pressure fitting features, screws, etc. . The upper swivel nozzle portion 303 and the lower swivel nozzle portion 304 are attached to the proximal closing tube segment 141. In at least one embodiment, for example, the upper swivel nozzle section 303 is fitted to the upper stem segment 145 by an adjustment 305 extending through an opening 306 in the upper stem segment 145 and the lower swiveling nozzle section 304 is fitted to the lower stem segment 143 by an adjustment 307 that extends through an opening 308 in the stem segment bottom 143. Meanwhile, the rotating nozzle 302 can be non-rotatably attached to the proximal closing tube segment 141 by other suitable means, so that rotation of the rotating nozzle 302 results in the rotation of the end actuator 20 about the axis longitudinal geometric AA.
[00086] As shown in Figure 13, the hinge nozzle 310 can be supplied in multiple parts for assembly purposes. In the illustrated embodiment, for example, the hinge nozzle 310 is formed from a right nozzle portion 311 and a left nozzle portion 313. The right and left nozzle portions 311, 313 can be manufactured from, for example , glass-loaded polycarbonate and can be interconnected by friction columns / holes 345, 347. However, the right and left nozzle portions 311, 313 can be fixed by adhesive, welding, pressure fitting features, appropriate screws etc. In various non-limiting embodiments, the pivot nozzle 310 is pivotally mounted to the lower and upper pins 220, 222, respectively. The upper pin 220 is attached to the upper stem segment 145 and the lower pin 222 is attached to the lower stem segment 143. The lower and upper pins 220, 222 are coaxially aligned and define a nozzle geometric axis CC, around which the hinge nozzle 310 can pivot in relation to the proximal closing tube segment 141. As can be seen, more particularly, in Figure 11, an orifice 319 is provided through the proximal end 314 of the hinge nozzle 310. The orifice 319 is dimensioned in relation to the closing tube section 141 to allow the pivot nozzle 310 to be pivoted around the nozzle geometry axis CC, as will be discussed in more detail below.
[00087] In the non-limiting embodiment of Figure 13, the hinge control system 300 includes a hinge assembly 230. In at least one embodiment, the hinge assembly 230 may comprise a right hinge rod 232 and a left hinge rod 234. Left and right pivot rods 232, 234 can be configured as shown in Figure 14 and made from stainless steel or other suitable material. As discussed above, when the left and right articulation rods are received within the proximal closing tube segment 141, they can be moved axially there, in relation to each other. When received within the proximal closing tube segment 141, the left and right pivot rods 232, 234 define a centrally arranged elongated groove 236, which is configured to accommodate the axial movement of the firing bar 180. A right pivot band 238 protrudes distally from a distal end 233 of the right pivot rod 232 and a left pivot band 240 protrudes distally from the distal end 239 of the left pivot rod 234. In various non-limiting embodiments, the articulation bands 238 , 240 are attached to the projection 96. For example, the strips 238, 240 can be pivotally attached to the projection 96.
[00088] The articulation assembly 230 is configured to interface with the articulation nozzle 310, so that the pivoting displacement of the articulation nozzle 310 around the geometric axis of nozzle CC, results in the actuation of the articulation assembly 230 which, finally, it makes the end actuator 20 articulate around the geometric axis of articulation BB in the articulation pivot 50. More specifically, and with reference to Figures 14 to 17, the right articulation rod 232 has a right pivot pin 320 which is attached to it and protrudes laterally from it through a straight groove 251 in the stem closure tube section 141. In various non-limiting embodiments, a ball 321 can be provided at the end of the right pivot pin 320 and be received, rotationally, within an opening 323 in the articulation nozzle 310. Similarly, the left articulation rod 234 has a left pivot pin 330 that is attached to it and protrudes laterally from there through a left groove 255 in the proximal closing tube segment 141. A ball 332 can be provided at the end of the left pivot pin 330 and be received rotatably within an opening 334 in the hinge nozzle 310.
[00089] The operation of the articulation control system 300 can be understood from the reference to Figures 14 to 16. Figure 14 illustrates the articulation of the end actuator 20 to the left of the articulation pivot 50. To perform this range of articulation, the doctor pivots the articulation nozzle 310 in the direction of action, represented by the arrow "E" in Figure 14. When the articulation nozzle 310 is pivoted in the "E" direction, the right articulation rod 232 is moved in the distal direction "DD" and the left pivot rod 234 is moved in the proximal direction "PD". Such movement of the left and right articulation rods 232, 234 results in the application of an impulse movement to the projection 96 by the right articulation band 238 and a pulling movement to the projection 96 by the left articulation band 240, resulting in the articulation of the actuator of end 20 as shown. Figure 15 illustrates the end actuator 20 in coaxial alignment with the stem 14 (for example, in a non-hinged position). Such an end actuator orientation can be employed, for example, during insertion into the patient, of the end actuator 20 through a trocar cannula (not shown) or other opening. Figure 16 illustrates the articulation of the end actuator 20 to the right of the articulation pivot 50. To perform this articulation band, the doctor pivots the articulation nozzle 310 in the direction of action represented by the arrow "F" in Figure 15. When the articulation nozzle 310 is pivoted in the "F" direction, the right articulation rod 232 is moved in the proximal direction "PD" and the left articulation rod 234 is moved in the distal "DD" direction. Such movement of the left and right articulation rods 232, 234 results in the application of a thrust movement to the projection 96 by the left articulation band 240 and a pulling movement to the projection 96 by the right articulation band 238, resulting in the articulation of the actuator of end 20 as shown. Although the hinge assembly 230, as described above, employs two elongated rods or hinge members, in alternative embodiments, only one elongated hinge member is employed.
[00090] Figures 17 to 23 illustrate another modality of the non-limiting joint control system of the present invention, generally designated as 400. These components, which are the same components employed in the modalities described above, will be marked with the same numbers of element and the elements versed in the technique can refer to the description presented earlier in this document, which explains its construction and operation. In various non-limiting embodiments, the hinge control system 400 includes a hinge nozzle 410 that is manufactured in multiple parts. For example, the hinge nozzle 410 has a right nozzle portion 412 that is axially movable with respect to a left nozzle portion 430. See Figure 21. In at least one non-limiting embodiment, the right nozzle portion 412 consists of an upper right portion 414 and a lower right portion 420. See Figure 19. The upper and lower right nozzle portions 412, 414 can be manufactured, for example, from glass-filled polycarbonate or other suitable material. Similarly, the left nozzle portion 430 consists of an upper left nozzle portion 432 and a lower left nozzle portion 440. The upper and lower left nozzle portions 432, 440 can be manufactured, for example, from polycarbonate with glass or other suitable material.
[00091] As can be seen in Figure 20, the upper right nozzle portion 414 is provided with a pair of spaced retaining band segments 416 and the lower right nozzle portion 420 is provided with a pair of retaining band segments spaced 422. When the upper and lower right nozzle portions 414, 420 are joined together, the retaining band segments 416 in the upper portion 414 cooperate with the retaining band segments 422 in the lower portion 420 to form retaining bands continuous annular rights, generally referred to as 424, the purpose of which will be discussed in further detail below. Similarly, the upper left nozzle portion 432 is provided with a pair of spaced retaining band segments 434 and the lower left nozzle portion 440 is provided with a pair of spaced retaining band segments 442. When the lower and upper left nozzles 432, 440 are joined, the retaining band segments 434 in the upper portion 432 cooperate with the retaining band segments 442 in the lower portion 440 to form continuous annular left retaining bands, generally referred to as 444.
[00092] In at least one non-limiting embodiment, the hinge control system 400 includes a hinge assembly 230. In at least one embodiment, the hinge assembly 230 may comprise a right hinge rod 232 and a left hinge rod 234. Left and right pivot rods 232, 234 can be configured as shown in Figure 19 and made from stainless steel or other suitable material. The left and right pivot rods 232, 234, when movably supported within the proximal closing tube segment 141, as shown, serve to define a centrally arranged elongated groove 236 that is configured to accommodate the axial movement of the firing bar 180. A right pivot band 238 protrudes distally from a distal end 233 of the right pivot rod 232 and a left pivot band 240 projects distally from the distal end 239 of the left pivot rod 234. In various embodiments non-limiting, the articulation bands 238, 240 are fixed to the projection 96. For example, the bands 238, 240 can be attached to the projection 96. The left and right articulation rods 232, 234 are slidably inserted in the hollow proximal closing tube segment 141. Right pivot rod 232 has a right pivot pin 450 that is attached to it and protects itself laterally jets from it through a right groove 251 in the stem closure tube section 141. Similarly, the left pivot rod 234 has a left pivot pin 460 that is attached to it and protrudes laterally from it through a left groove 255 in the stem closure tube section 141. Such an arrangement allows the right hinge rod 232 and the second hinge rod to be independently axially movable within the proximal closing tube segment 141. The end of the pin right pivot pin 450 is configured to be received inside an opening 452 formed by the joined lower and upper right nozzle portions 414, 420. Similarly, the end of the left pivot pin 460 is configured to be received inside an opening 462 formed by the upper and lower left nozzle portions 432, 440.
[00093] To look at least like one embodiment, the upper nozzle portions 414, 432 are joined together to form a temporary upper nozzle assembly 433, but remain not attached to each other, as shown in Figure 19. As is also illustrated in Figure 19, the lower nozzle portions 420, 440 are joined to form a temporary lower nozzle assembly 443, but remain unrelated to each other. Then, the temporary upper nozzle assembly 433 is joined to the temporary lower nozzle assembly 443 on the proximal closing tube segment 141, while capturing the right pivot pin 450 in the right opening 452 and the left pivot pin 460 in the left opening 462. In at least one non-limiting embodiment, the upper right nozzle portion 414 is provided with fixing columns 415 (FIG. 20) that are sized to be chained together by fixing holes 425 in the lower right nozzle portion, for retain these two portions 414, 420 to form the right nozzle section 412. Similarly, the lower left nozzle portion 440 is provided with fixing columns 445 which are sized to be fitted with friction into the fixing holes 435 in the upper left nozzle 432 to retain these two portions 440, 432 to form the left nozzle portion 430. However, other grip and / or adhesive arrangements may be employed for fixing r the upper right nozzle portion 414 to the lower right nozzle portion 420 and the upper left nozzle portion 432 and the lower left nozzle portion 440.
[00094] The operation of the articulation control system 400 can be understood from the reference to Figures 22 and 23. Figure 22 illustrates the articulation of the end actuator 20 to the left of the articulation pivot 50. To perform this range of articulation, the doctor moves axially the right nozzle portion 412 in the distal direction "DD" and the left nozzle portion 430 in the proximal direction "PD", which causes the right articulation rod 232 and the left articulation rod 234 move the end actuator to the left around the pivot point 50. Such movement of the left and right pivot rods 232, 234 results in the application of a thrust movement to the protrusion 96 by the right pivot band 238 and a pulling movement to the protrusion 96 by the left pivot band 240, resulting in the articulation of the end actuator 20, as shown. Figure 23 illustrates the articulation of the end actuator 20 to the right of the articulation pivot 50. To perform this articulation band, the doctor axially moves the right nozzle portion 412 in the proximal direction "PD" and the left nozzle portion 430 in the "DD" distal direction, which causes the right pivot rod 232 and the left pivot rod 234 to move the end actuator 20 to the right around the pivot point 50. Such movement of the left and right pivot rods 232, 234 results in the application of a thrust movement to the projection 96 by the left pivot band 240 and a pull movement to the projection 96 by the right pivot band 238, resulting in the articulation of the end actuator 20, as shown. Although the hinge assembly 230, as described above, employs two elongated rods or hinge members, in alternative embodiments, only one elongated hinge member is employed.
[00095] Figures 24 and 25 illustrate an alternative nozzle modality 410 'that can be employed, instead of the nozzle modality 410 described above. In this embodiment, the nozzle 410 'is manufactured from a right nozzle portion 412' that is axially movable with respect to a left nozzle portion 430 '. As can be seen in these FIGS., The left nozzle portion 430 'has a left axial opening 460 therein which defines a left axial shoulder 462, which is adapted to be slidably engaged by a right latch portion 470. similarly, the right nozzle portion 412 has a right axial opening 472 that has a right axial shoulder 474, which is adapted to be slidably engaged by a left latch portion 464. Such an arrangement serves to join the portion of right nozzle 412 'to the left nozzle portion 430, around the proximal closing rod 141, while allowing these portions to move axially with respect to each other. The right nozzle portion 412 'has a right opening 452' there to receive the right pivot pin 450 therein and the left nozzle portion 430 'has a left opening 462' therein to receive the left pivot pin 460 therein. The alternative nozzle 410 'is otherwise operated in the manner described above to articulate the end actuator 20 around the pivot pivot 50 and the pivot geometry axis B-B.
[00096] Figures 26 to 33 illustrate another modality, not limiting the present invention, of the articulation control system, generally designated as 500. These components, which are the same components used in the modalities described above, will be marked with the same Element numbers and elements skilled in the art can refer to the description presented earlier in this document, which explains its construction and operation. In at least one embodiment, the hinge control system 500 includes a hinge nozzle 510 that is manufactured in multiple parts. For example, the hinge nozzle 510 has a right nozzle portion 512 that is configured to be attached to a left nozzle portion 530. See Figure 29. In at least one non-limiting embodiment, the right nozzle portion 512 can be provided with clamping columns 513 formed therein, which are dimensioned to be engaged by friction in corresponding clamping openings (not shown) in the left nozzle portion 530. The right nozzle portion 512, similarly, may have clamping openings 515 that are dimensioned to frictionally match corresponding fixing columns 531 to the left nozzle portion 530, to couple the right and left nozzle portions 512, 530. See Figure 29. Other fixing arrangements such as adhesive, welding, mechanical closures, snap-fit features, etc. can be used to fix the left and right nozzle portions. In various non-limiting embodiments, the right nozzle portion 512 has a proximal end 514 with buttons or actuating protuberances 516 formed therein. The right nozzle portion 512 additionally has a distal end 517 which has an adjustment 518 formed therein for reception within an adjustment opening 519 in the proximal closing tube segment 141, for non-rotating attachment of the right nozzle portion 512 to the proximal closing tube segment 141. Similarly, the left mouth portion 530 has a proximal end 534 with buttons or actuating protuberances 516 formed therein. The left nozzle portion 530 has, in addition, a distal end 537 which has an adjustment 538 formed therein for receiving in an adjustment opening 539 in the proximal closing tube segment 141, for non-rotating attachment of the left nozzle portion 530 to the proximal closing tube segment 141. See Figures 31 to 33.
[00097] In at least one non-limiting embodiment, the hinge control system 500 includes a hinge assembly 230. In at least one embodiment, the hinge assembly 230 may comprise a right hinge rod 232 and a left hinge rod 234. Left and right pivot rods 232, 234 can be configured as shown in Figure 29, and made from stainless steel or other suitable material. The left and right pivot rods 232, 234, when movably supported within the proximal closing tube segment 141, as shown, serve to define a centrally arranged elongated groove 236 that is configured to accommodate the axial movement of the firing bar 180. A right pivot band 238 protrudes distally from a distal end 233 of the right pivot rod 232 and a left pivot band 240 projects distally from the distal end 239 of the left pivot rod 234. In various embodiments , the hinge strips 238, 240 are attached to the projection 96. For example, the strips 238, 240 can be pivotally attached to the projection 96. The left and right hinge rods 232, 234 are slidably inserted into the hinge segment. hollow proximal closing tube 141. The right hinge rod 232 has a right pivot pin 550 that is attached to it and protrudes laterally from it through a right groove 251 in the proximal closing tube segment 141. Similarly, the left pivot rod 234 has a left pivot pin 560 that is attached to it and projects laterally from it through a left slot 255 in the proximal closing tube segment 141.
[00098] In at least one non-limiting mode, the articulation control 500 includes an actuator set 562 that projects through openings 564, 566 in the nozzle 510 and is selectively pivotable around a geometric axis of the HH actuator, which is substantially transversal to the longitudinal geometric axis AA. In various forms, actuator assembly 562 comprises a first portion of actuator 570 that is coupled to a second portion of actuator 580. The first portion of actuator 570 has a pivot orifice 571 through it which is pivotally adapted to receive , a first actuator pin 590 that is coupled to the proximal closing tube segment 141. See Figures 28 and 19. Similarly, the second portion of actuator 580 has a pivot hole 581 through it that is adapted to receive, pivotally, a second actuator pin 592 which is coupled to the proximal closing tube segment 141. The first and second actuator pins 590, 592 serve to define the geometric axis of the HH actuator, which is substantially transversal to the longitudinal geometric axis AA and around which the actuator assembly 562 can pivot. The first actuator portion 570 can be attached to the second actuator portion 580 by a variety of methods. In the illustrated version, for example, the first actuator portion 570 has a pair of clamping columns 572 that are sized to be received with friction within corresponding clamping holes (not shown) in the second actuator portion 580. Similarly, the second actuator portion 580 may have clamping columns 580 that are sized to be received with friction within the clamping holes 574 in the first actuator portion, so that when the first and second actuator portions 570, 580 are joined, the they form the actuator set 562. However, the first and second actuator portions 570, 580 can be coupled with the use of any suitable means such as adhesive, pressure snapping features, fasteners, etc.
[00099] As can be seen in Figures 28 and 29, the first portion of actuator 570 interfaces operationally with the first articulation rod 232 to effect its axial movement within the proximal closing tube segment 141, by means of a first cam groove 576 which is configured to receive a portion of the right pivot pin 550 therein. Thus, by pivoting the first actuator portion 570 around the geometric axis of the HH actuator, the interaction between the first cam groove 576 and the right pivot pin 550 will cause the first pivot rod 232 to move axially in. of the proximal closing tube segment 141. Similarly, the second portion of actuator 580 interfaces operationally with the second articulation rod 234 to effect axial movement within the proximal closing tube segment 141, by means of a second cam groove 586, configured to receive a portion of the left pivot pin 560 therein. Thus, when the second portion of actuator 580 pivots around the geometric axis of the actuator HH, the interaction between the second cam groove 586 and the left pivot pin 560 will cause the second pivot rod 234 to move axially within the proximal closure tube segment 141.
[000100] The operation of the articulation control system 500 can be understood from the reference to Figures 26 and 31 to 33. Turning first to Figure 26, to rotate the proximal closing tube segment 141 and, finally, the actuator endpoint 20 (shown in Figures 31 to 33) around the longitudinal axis AA, the physician simply rotates the nozzle 510 around the longitudinal axis AA, as represented by the arrow "I" in Figure 26. Figure 31 illustrates the articulation of the end actuator 20 to the left of the articulation pivot 50. To perform this joint range, the physician simply pivots the actuator assembly 562 in the "J" direction (shown in Figure 30) around the geometric axis of the HH actuator . Such movement of the actuator assembly 562 results in the interaction between the right pivot pin 550 and the right cam groove 576, which results in the axial movement of the right pivot rod 232 in the distal direction "DD". Such movement of the actuator assembly 562 also results in the interaction between the left pivot pin 560 and the left cam groove 586, which simultaneously results in axial movement of the left actuating rod 234 in the proximal "PD" direction. Such movement of the left and right articulation rods 232, 234 results in the application of an impulse movement to the projection 96 by the right articulation band 238 and a pulling movement to the projection 96 by the left articulation band 240, resulting in the articulation of the actuator of end 20 as shown. Figure 33 illustrates the articulation of the end actuator 20 to the right of the articulation pivot 50. To perform this joint range, the doctor pivots the actuator assembly 562 in the "K" direction (shown in Figure 30) around the axis geometry of the HH actuator. Such movement of the actuator assembly 562 results in the interaction between the right pivot pin 550 and the right cam groove 576, which results in the axial movement of the right pivot rod 232 in the distal direction "DD". Such movement of the actuator assembly 562 also results in the interaction between the left pivot pin 560 and the left cam groove 586 which simultaneously results in axial movement of the left actuating rod 234 in the proximal "PD" direction. Such movement of the left and right articulation rods 232, 234 results in the application of an impulse movement to the projection 96 by the right articulation band 240 and a pulling movement to the projection 96 by the left articulation band 238, which results in the articulation of the actuator. endpoint 20 as shown. Although the hinge assembly 230, as described above, employs two elongated rods or hinge members, in alternative embodiments, only one elongated hinge member is employed.
[000101] Figures 34 to 42 illustrate another modality, not limiting the present invention, of the articulation control system, generally designated as 600. These components, which are the same components used in the modalities described above, will be marked with the same Element numbers and elements skilled in the art can refer to the description presented earlier in this document, which explains its construction and operation. In this embodiment, the hinge control system 600 includes a hinge nozzle 610 that is manufactured in multiple parts. For example, the hinge nozzle 610 has an upper nozzle portion 612 that is configured to be attached to a lower nozzle portion 630. See Figure 38. In at least one non-limiting embodiment, the upper nozzle portion 612 can be equipped with fixing columns (not shown) formed in it, which are dimensioned to be engaged by friction in corresponding fixing openings 631 in the lower nozzle portion 630. Other fixing arrangements such as adhesive, mechanical closures, pressure fitting features, etc. ., can be used to fix the upper and lower nozzle portions 612, 630. In various non-limiting embodiments, the upper nozzle portion 612 has a proximal end 614 with buttons or actuation protrusions 616 formed therein. Similarly, the lower nozzle portion 630 has a proximal end 634 with buttons or actuating protuberances 616 formed therein.
[000102] In at least one non-limiting embodiment, the articulation control system 600 includes an articulation assembly 700. In at least one embodiment, the articulation assembly 700 may comprise a right articulation band 710 and a left articulation band 730, which are received with a proximal closing tube segment 750. The right articulation band 710 has an elongated right band portion 712 and a proximal actuation portion 714. Similarly, the left articulation band 730 has a portion left elongated band 732 and proximal actuating portion 734. Left and right hinge bands 710, 730 can be manufactured from stainless steel or other suitable material. The proximal closing tube segment 750 comprises a hollow tube that can be manufactured, for example, from stainless steel or other suitable material. In at least one non-limiting embodiment, the hollow proximal closing rod segment 750 has a right band passage 752 and a left band passage 754 formed on its wall. The center of the proximal closing tube segment 750 provides a passageway to accommodate the back or proximal frame portion of the device (not shown) as well as the firing bar (not shown), in the various ways described above. As shown in Figure 38, the elongated right pivot band portion 712 is slidably supported within the right band pass 752 and the elongated left pivot band portion 732 is slidably supported at the left band pass 754. In various non-limiting modalities, the articulation strips 712, 732 are attached to the projection 96. See Figures 40 and 42. For example, the strips 238, 240 can be articulated to the projection 96. The left and right articulation rods 232, 234 are slidably inserted into the hollow proximal closing tube segment 141. The right pivot rod 232 has a right pivot pin 550 that is attached to it and projects laterally from it through a right groove 251 in the proximal closing tube segment 141. Similarly, left pivot rod 234 has a left pivot pin 560 that is attached to it and protrudes laterally from it through a left groove 255 in the proximal closing tube segment 141.
[000103] The nozzle 610 is non-rotatably attached to the proximal closing rod segment 700, so that rotation of the nozzle 610 around the longitudinal axis AA will result in the rotation of the end actuator 20 about the geometric axis longitudinal A- A. In at least one non-limiting mode, the nozzle 610 has a setting 613 that extends to a groove 751 in the proximal closing tube segment 750. See Figure 38. This arrangement serves to fasten, in a non- the nozzle 610 to the proximal closing tube segment 750, while facilitating the axial movement of the nozzle 610 with respect to it. As can also be seen in Figures 37 and 38, the upper nozzle portion 612 additionally has an actuation notch 640 formed therein that is configured to operationally engage a pivot member or actuation pivot plate 650. In at least one non-limiting embodiment, the pivot plate 650 comprises a portion of the right pivot plate 652 and a portion of the left pivot plate 670. The right pivot portion has a pivot pin 654 formed therein that is adapted to be hingedly received inside a pivot hole 780 in the proximal closing tube segment 750. See Figure 42. Similarly, the left pivot plate portion 670 has a right pivot pin 672 formed therein that is adapted to be received articulated within a pivot hole 682 in the proximal closing tube segment 750. The right and left pivot pins 654, 672 are coaxially aligned with each other to define a geometric axis of actuation LL, around the al the pivot plate 650 can pivot and which is substantially transversal to the longitudinal geometric axis "L-L". The right and left pivot plate portions 650, 670 are fixed by columns (not shown) and holes 655, which are designed for friction engagement. The right and left pivot plate portions 650, 670 can also be attached by adhesive or other suitable fixation arrangement. As can be seen in Figures 36, 37 and 39, the proximal closing tube segment 750 has lower and upper clearance slots 753, 755 in it, to facilitate the pivoting displacement of the pivot plate 650 around the geometric actuation axis LL (FIG. 36).
[000104] As can be seen further in Figures 37 to 40 and 41, the right pivot plate portion 650 has a lower right actuating groove 656 which is configured to align with a corresponding lower left actuating groove 674 in the left pivot plate 670, to form a lower actuating groove 676 in pivot plate 650 to receive and operationally engage an actuator flap 716 formed in the actuator portion 714 of the actuator band assembly 710. The right pivot plate portion 650 has an upper right hinge groove 658 that is configured to align with a corresponding upper left hinge groove (not shown) on the left pivot plate portion 670, to form an upper hinge groove 678 on the pivot plate 650 for receiving and operationally engaging an actuator tab 736 formed in the actuator portion 734 of the actuator band assembly 730.
[000105] The operation of the articulation control system 600 can be understood from the reference to Figures 39 to 42. Turning to Figures 39 and 40 first, to pivot the end actuator 20 in the right direction around the pivot 50, the doctor pushes the nozzle 610 axially in the distal direction "DD". Such movement of the nozzle 610 in the distal direction "DD" causes the pivot plate 650 to pivot around the geometric axis of actuation LL in the "M" direction (FIG. 39) thus pushing the left pivot band assembly 730 in the direction distal "DD" and pulling the right articulation band assembly 750 in the proximal direction "PD". Such an axial movement of the nozzle 610 and the left and right pivot band assemblies 710, 730 results in the application of a thrust movement to the projection 96 by the left pivot band assembly 730 and a pull to the projection 96 by the projection band assembly. right pivot 710 which results in pivoting the end actuator 20, as shown in Figure 40. Similarly, to pivot the end actuator 20 around pivot point 50 in the left direction (FIG. 42), the doctor pulls the nozzle 610 in the proximal direction "PD". Such movement of the nozzle 610 in the proximal direction "PD" causes the pivot plate 650 to pivot around the geometric axis of actuation LL in the "N" direction (FIG. 41) thus pushing the right pivot band assembly 710 in the direction distal "DD" and pulling the left articulation band assembly 750 in the proximal direction "PD". Such axial movement of the nozzle 610 and the left and right pivot band assemblies 710, 730 results in the application of a thrust movement to the projection 96 by the right pivot band assembly 710 and a pulling movement to the projection 96 by the band assembly left pivot pin 730, which results in pivoting the end actuator 20, as shown in Figure 42. To rotate the end actuator 20 around the longitudinal axis AA, the doctor simply rotates the nozzle 610 around the longitudinal axis AA . Such an action can be performed by a portion of the same hand that is supporting the instrument's cable. Although the hinge assembly 230, as described above, employs two elongated rods or hinge members, in alternative embodiments, only one elongated hinge member is employed.
[000106] Figures 43 to 50 illustrate another modality of the articulation control system of the present invention, generally designated as 800. These components, which are the same components employed in the modalities described above, will be marked with the same element numbers and the elements versed in the technique can refer to the description presented earlier in this document that explains its construction and operation. In at least one non-limiting embodiment, the joint control system 800 includes a joint nozzle 810 which is manufactured in multiple parts. For example, hinge nozzle 810 has a first nozzle portion 812 that is configured to be attached to a second nozzle portion 830. See Figures 44 to 46. In at least one non-limiting embodiment, the right nozzle portion 812 and the left nozzle portion 830 are fixed by a collection of columns 813, which are received by friction in corresponding openings 815. Other fastening arrangements such as adhesive, mechanical closures, snap-on features, etc. they can be used to fix the first and second nozzle portions 812, 830. In various non-limiting embodiments, the first nozzle portion 812 has a proximal end 814 with buttons or actuating protuberances 816 formed therein. Similarly, the second mouthpiece portion 830 has a proximal end 834 with buttons or actuating protuberances 816 formed therein.
[000107] In at least one non-limiting embodiment, the articulation control system 800 includes a selectively lockable articulation assembly 900. In at least one non-limiting embodiment, the articulation assembly 900 may comprise a 910 right articulation band and a left articulation band 930 which are received with a back segment 850, which is attached to the instrument cable (not shown). The right pivot band 910 has an elongated right band portion 912 and a proximal actuation portion 914 that has a right actuation flap 916 formed therein. Similarly, the left hinge band 930 has a left elongated band portion 932 and a proximal acting portion 934 that has a left acting flap 936 formed therein. The left and right hinge bands 910, 930 can be manufactured from stainless steel or other suitable material.
[000108] In various non-limiting embodiments, the back segment 850 comprises a hollow tube that can be manufactured, for example, from stainless steel or other suitable material. In at least one non-limiting embodiment, the hollow back segment 850 has a right band passage 852 and a left band passage 854 formed on its wall. The center of the back segment 850 provides a passage 851 sized and configured to accommodate the back or proximal frame portion of the device 100 (shown in Figure 2) as well as the firing bar 180 (shown in Figure 2), in the various ways described above. As shown in Figure 47, the elongated right pivot band portion 912 is slidably supported within the right band pass 852 and the elongated left pivot band portion 932 is slidably supported at the left band pass 854. In In various non-limiting embodiments, the hinge bands 912, 932 are attached to the protrusion 96 of the end actuator frame 90, as discussed above.
[000109] As can be seen in Figures 44 to 47 and 49, in at least one non-limiting mode, the left and right actuation flaps 916, 936 are configured for operational engagement with a pivot plate or actuation 980. In several modalities , pivot plate 980 comprises a first portion of pivot plate 982 and a second portion of pivot plate 990. The first portion of pivot plate 982 has a first pivot pin 984 formed thereon which is adapted to be received in a manner articulated within a first pivot hole 853 in the back segment 850. See Figures 44 and 46. Similarly, the second portion of pivot plate 990 has a second pivot pin 992 formed therein that is adapted to be received from pivotably within a second pivot hole 852 in the back segment 850. The first pivot pin 984 also extends through a first elongated groove 954 in a proximal closing tube segment 950. Similarly, the second pivot pinpivot 992 extends through a second elongated groove 956 in the proximal closing tube segment 950. Such an arrangement allows the proximal closing tube segment 950 to move axially in the back segment 850, while facilitating pivoting displacement of the 980 pivot plate in this regard. The first and second pivot pins 984, 992 are coaxially aligned with each other to define an N-N actuation geometry axis, around which the pivot plate 980 can pivot and which is substantially transversal to the longitudinal geometric axis "A-A". See Figure 45. The first and second portions of pivot plate 982, 990 are secured by columns 983 and holes 993 that are designed for friction engagement. The first and second pivot plate portions 982, 990 can also be attached by adhesive, welding, snap-fit features or other suitable closing arrangements.
[000110] As can be seen in Figure 49, the back segment 850 has a right flap groove 860 through which the right actuator flap 916 extends. The back segment 850 additionally has a left flap groove 862 through which the left pivot flap 936 extends. In addition, the right actuator flap 916 extends through a right groove 960 in the proximal closing tube segment 950 and the left actuator flap 936 extends through a left groove 962 in the proximal closing tube segment 950. According to can also be seen in Figures 44 to 47, the first pivot plate portion 982 has a right acting groove 987 that is configured to align with a corresponding right acting groove (not shown) in the second pivot plate portion 990 , to form a right pivot groove 995 in the pivot plate 980 to receive and operationally engage the right actuator flap 916 therein. Similarly, the right pivot plate portion 982 has a left acting groove 988 that is configured to align with a corresponding left acting groove 996 in the second pivot plate portion 990 to form a left pivot groove 997 in the pivot plate 980 to receive and operationally engage the left actuator flap 936 therein.
[000111] In various non-limiting embodiments, the hinge nozzle 810 is non-rotatably attached to a proximal closing rod segment 950, so that rotation of the hinge nozzle 610 around the longitudinal geometric axis AA will result in rotation of the end actuator 20 about the longitudinal geometric axis AA. In at least one non-limiting embodiment, the pivot nozzle 810 has an adjustment 818 that extends into a corresponding elongated groove 951 in the proximal closing tube segment 950 and the corresponding groove 859 in the back segment 850, as shown in Figure 49 Such an arrangement facilitates the axial movement of the hinge nozzle 810 with respect to the proximal closing tube segment 950 and the back segment 950, while also facilitating the rotation of the proximal closing tube segment 950 as a unit , by rotating the nozzle 810 around the longitudinal geometric axis AA. As can also be seen in Figures 44 and 49, an actuator notch 817 is provided in the pivot nozzle 810 to engage pivot plate 980. In this way, the axial movement of nozzle 810 will cause pivot plate 980 to pivot in around the geometric axis of actuation NN.
[000112] To pivot the end actuator in the left direction around the pivot point or geometric axis of articulation, the doctor moves the articulation nozzle 810 axially in the distal direction "DD". Such movement of the articulation nozzle 810 in the distal direction "DD" causes the pivot plate 980 to pivot around the geometric axis of actuation NN, thus moving the right articulation band 910 in the distal direction "DD" and pulling the left articulation 930 in the proximal direction "PD". Such axial movement of the pivot nozzle 810 and the left and right pivot bands 910, 930 results in the application of a thrust movement to the projection 96 by the right pivot band 910 and a pulling movement to the projection 96 by the pivot band assembly. left 930, which results in the articulation of the end actuator. See Figure 49. Similarly, to pivot the end actuator around the pivot point or the hinge axis in the right direction, the doctor pulls the hinge nozzle 810 in the proximal "PD" direction. Such movement of the nozzle 810 in the proximal direction "PD" causes the pivot plate 980 to pivot around the geometric axis of actuation NN thus pushing the left articulation band 930 in the distal direction "DD" and pulling the right articulation band 910 in the "PD" proximal direction. Such an axial movement of the pivot nozzle 810 and the left and right pivot bands 910, 930 results in the application of a thrust movement to the projection 96 by the left pivot band 930 and a pulling movement to the projection 96 by the right pivot band 910. , which results in the articulation of the end actuator to the right of the longitudinal axis AA. To rotate the end actuator about the longitudinal axis A-A, the physician simply rotates the pivot nozzle 810 about the longitudinal axis A-A.
[000113] As discussed above, the proximal closing tube segment 950 interfaces with the closing trigger, so that when the doctor acts on the closing trigger, the proximal closing tube segment 950 moves in the distal direction. In various non-limiting embodiments, the distal end portion of the proximal closing tube segment can be configured as shown, for example, in Figure 2, to be pivotally coupled to the distal closing tube segment 150, to apply the movements of opening and closing to the fixed claw 130. In several non-limiting modes, the articulation locking system 1000 is configured to be locked when the proximal closing tube segment 950 is axially moved in the distal direction "DD", and to be unlocked when the proximal closing tube segment 950 is moved axially in the proximal direction "PD".
[000114] More specifically, as can be seen in Figure 45, the right articulation band 910 has a plurality of right locking holders 1010 formed therein. Each holder 1010 corresponds to a particular angular or hinged orientation of the end actuator about the hinge axis. The right locking holders 1010 are configured to be engaged by a right locking ball 1012, which is movably supported in a right locking hole 1014 in the back segment 850. Similarly, the left pivot band 930 has a plurality of left locking holders 1020 formed thereon, which are configured to be engaged by a left locking ball 1022, which is movably supported in a left locking hole 1024 in the back segment 850. See Figure 49. The ball right locking cavity 1012 is received in an elongated right locking cavity 1016 formed in the proximal closing tube segment 950. Such elongated locking cavity 1016 provides sufficient clearance for the right locking ball 1012 to move radially, depending on the articulation band right 912 is moved axially within the back segment 850. As can be seen more particularly in Figures at 48 and 50, the proximal end 1017 of the elongated right locking cavity 1016 has a locking elevation 1018 formed therein. Similarly, the left locking ball 1022 is received in an elongated left locking cavity 1026 formed in the proximal closing tube segment 950. Such elongated locking cavity 1026 provides sufficient clearance for the left locking ball 1022 to move radially. , as the left pivot band 932 is moved axially within the back segment 850. As can be seen more particularly in Figure 49, the proximal end of the elongated left locking cavity 1026 has a left locking elevation 1028 formed therein.
[000115] The operation of the joint control system 800 and the joint locking system 1000 will now be described, with reference to Figures 47 to 50. In various non-limiting modalities, when the physician wishes to articulate the end actuator around the geometric axis of articulation, the nozzle 810 is axially moved in a desired direction, as described above. The doctor can perform this action with the same hand he is using to pick up and support the instrument's handle. During the articulation process, the closing trigger was not actuated and the proximal closing tube 950 is in the "open" position, as shown in Figures 47 and 48. As the right articulation band 912 is moved axially, it is allowed to the right locking ball 1012 moves sufficiently in the opposite direction radially to the right pivot band 912, to allow it to move axially like this, and as the left pivot band 932 is moved axially, the ball is allowed to move left locking pin 1022 moves sufficiently in the opposite direction, radially to the left pivot band 932 to allow it to move axially like this. As the doctor advances the nozzle 810 in the proper axial direction and the left and right articulation bands 912, 932 move beyond the right and left locking balls 1012, 1022, respectively, the doctor receives tactile feedback, as per the locking holders 1010 , 1020 movably engage the locking balls 1012, 1022, respectively. Once the doctor has reached the desired amount of articulation, which corresponds to a position in which the right locking ball 1012 engages a right locking holder 1010, which corresponds to that articulated position, and the left locking ball 1022, so similarly, engage the left locking holder 1020 that corresponds to that articulated position, the doctor can then activate the closing trigger.
[000116] As discussed above, when the physician activates the closing trigger, the proximal closing tube segment 950 is axially advanced in the distal "DD" direction. As the proximal closing tube segment 950 is distally advanced, the right locking elevation 1018 engages the right locking ball 1012 and presses it radially inward for the locking engagement with the corresponding right locking holder 1010. Similarly, the left locking lift 1028 engages the left locking ball 1022 and presses it radially inward for the locking engagement with the corresponding left locking holder 1020. The additional axial feed of the proximal closing tube segment 950 in the distal direction "DD "will continue to press the right and left locking balls 1012, 1022 into the locking hitch to retain the end actuator in the desired articulated position while the fixed clamp is closed and the instrument is additionally used. After the end actuator has been used "fired" and the closing trigger is released to return to the open position, the proximal closing tube segment 950 is moved in the proximal "PD" direction to the initial position where the pivot 912, 932 can be axially moved, if desired, to orient the end actuator in the desired position for removal from the surgical site. Thus, such a joint locking system is essentially activated by applying closing movements to the end actuator. Although the joint assembly, as described above, employs two elongated rods or joint members, in alternative modalities, only one elongated joint member is employed. Similarly, in alternative embodiments, the hinge locking system can only employ a locking ball arrangement configured to engage the locking holders with the corresponding elongated hinge member. Furthermore, in modalities that employ two elongated articulation members, only one locking sphere can be used to lock one of the articulation members by applying a closing force to the end actuator.
[000117] The devices described here can be designed to be discarded after a single use, or they can be designed for use multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device can be disassembled, and any number of particular parts or parts of the device can be selectively exchanged or removed, in any combination. After cleaning and / or exchanging particular parts, the device can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately before a surgical procedure. Those skilled in the art will appreciate that the reconditioning of a device can use a variety of techniques for disassembly, cleaning or replacement, and reassembly. The use of such techniques, and the resulting refurbished device are all within the scope of the present application.
[000118] Preferably, the inventions described here will be processed before surgery. First, a new or used instrument is obtained and, 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 pouch. The container and the instrument are then placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays or high-energy electrons. The radiation kills bacteria on the instrument and the container. The sterile instrument can then be stored in a sterile container. The sterile container keeps the instrument sterile until it is opened at the medical facility.
[000119] Any patent, publication or other description material, in whole or in part, which is said to be incorporated into the present invention for reference purposes, is incorporated into the present invention only to the extent that the incorporated materials do not come into effect. conflict with existing definitions, statements or other description material presented in this description. Thus, and as far as necessary, the description as explicitly determined herein, replaces any conflicting material incorporated here for reference. Any materials, or portions thereof, which are considered to be incorporated by reference in the present invention, but which conflict with definitions, statements, or other description materials existing herein, will be incorporated here only to the extent that none conflict arises between the embedded material and the existing description material.
[000120] Although this invention has been described as having exemplary designs, the present invention can be further modified within the spirit and scope of the description. It is therefore intended that this application will cover any variations, uses or adaptations of the invention using its general principles. In addition, this application is intended to cover such changes to the present description, as is known or customary practice in the art to which this invention belongs.

权利要求:
Claims (14)
[0001]
1. Surgical instrument (10), characterized by the fact that it comprises: an elongated nail (14) that defines a longitudinal geometric axis; an end actuator (20) coupled to the elongated rod (14) for selective pivoting displacement in relation to the elongated rod (14), the end actuator (20) has at least one movable portion responsive to the opening and closing movements; a closing member that interfaces with at least a movable portion of the end actuator (20) to selectively apply the closing movement to it; an articulation control system (800), which interfaces operationally with the end actuator (20), to apply articulation movements to it; and a hinge lock system that interfaces with the hinge control system (800) and the closing member, the hinge lock system is configured to move from an unlocked position, where the hinge control system (800) applies the articulation movements to the end actuator (20), and a locked position, in which the joint lock system prevents the articulation control system (800) from applying the articulation movements to the end actuator ( 20) by applying the closing movement by the closing member. wherein the articulation control system (800) comprises a nozzle (810) supported in relation to the elongated stem (14), so that the nozzle (810) can be moved axially in the first and second axial directions in relation to the stem elongated (14) and rotation of the nozzle (810) about the longitudinal axis causes the end actuator (20) to rotate around the longitudinal axis, and in which the articulation control system (800) comprises an articulation assembly (900) which interfaces operationally with the end actuator (20) and the nozzle (810) so that the movement of the nozzle (810) in the first axial direction causes the pivot assembly (900) to apply a first pivot movement to the end actuator (20) and the movement of the nozzle (810) in the second axial direction causes the pivot assembly (900) to apply a second pivot movement to the end actuator (20).
[0002]
2. Surgical instrument according to claim 1, characterized by the fact that the joint assembly (900) comprises: a first elongated joint member (910) that has a first proximal end and a first distal end, in which the the first distal end interfaces operationally with the end actuator (20) and the first proximal end interfaces operationally with the nozzle (810); and a second elongated hinge member (930), which has a second proximal end and a second distal end, where the second distal end interfaces operatively with the end actuator (20) and where the second proximal end does operationally interface with the nozzle (810).
[0003]
3. Surgical instrument (10), according to claim 2, characterized by the fact that the joint locking system comprises a first locking member that interfaces mobilely with the closing member and the first elongated joint member (910) so that, by applying the closing movement to the end actuator (20) by the closing member, the first locking member is moved to locking engagement with the first elongated hinge member (910).
[0004]
4. Surgical instrument (10), according to claim 3, characterized by the fact that the end actuator (20) is articulable for several articulated positions and in which the first elongated articulation member (910) comprises a plurality of first locking positions (1010) that correspond to the various articulated positions.
[0005]
5. Surgical instrument (10) according to claim 4, characterized by the fact that the first locking member comprises a first locking ball (1012) movably supported for displacement between an unlocked position and the plurality of locked positions .
[0006]
6. Surgical instrument (10), according to claim 3, characterized by the fact that the joint locking system still comprises a second locking member that interfaces mobilely with the closing member and the second joint member elongated (930) so that by applying the closing movement to the end actuator (20) by the closing member, the second locking member is moved to locking engagement with the second elongated hinge member (930).
[0007]
7. Surgical instrument (10) according to claim 6, characterized in that the second elongated hinge member (930) defines a plurality of second locking positions (1020) that correspond to the plurality of the first locking positions.
[0008]
8. Surgical instrument (10) according to claim 7, characterized in that the second locking member comprises a second locking sphere (1022) movably supported for mobile displacement between the closing member and the second member elongated hinge (930), and wherein the plurality of second locking positions comprises a plurality of second locking holders (1020) on the second elongated hinge member (930) for selective locking engagement with the second locking sphere.
[0009]
9. Surgical instrument (10), according to claim 1, characterized by the fact that the end actuator (20) comprises a surgical cutting and clamping instrument.
[0010]
10. Surgical instrument (10) according to claim 1, characterized by the fact that the closing member interfaces with at least one movable portion to apply the opening movement to it when the closing member is moved in one direction opening, and the hinge lock system comprises: a locking member that interfaces operatively with the closing member and the first elongated hinge member (910), so that when the closing member is moved in the closing direction, the locking member latches the elongated first hinge member (910) in a locked manner to prevent movement in the first and second actuation directions and when the closing member is moved in the opening direction, the limb locking mechanism disengages the first pivot member (910) to allow the first pivot member (910) to move in the first and second actuation directions.
[0011]
11. Surgical instrument (10) according to claim 10, characterized by the fact that the first elongated joint member (910) defines a plurality of first locking positions that correspond to the various articulated positions.
[0012]
12. Surgical instrument (10) according to claim 11, characterized in that the locking member comprises a first locking ball (1012) movably supported for radial displacement between the closing member and the first limb. elongated hinge (910), and wherein the plurality of locking positions comprises a plurality of first locking holders (1010) on the first elongated hinge member (910) for selective locking engagement with the first locking ball (1012).
[0013]
13. Surgical instrument (10), according to claim 10, characterized by the fact that it still comprises: a second elongated articulation member (930) mobilely supported in relation to the closing member; and a second locking member operatively interfacing with the closing member and the elongated second hinge member (930) so that when the closing member is moved in the closing direction, the second locking member engages in the second elongated hinge member (930) is lockable to prevent movement and when the closing member is moved in the opening direction, the second locking member disengages from the second elongated hinge member (930) to allow the second articulation member moves.
[0014]
14. Surgical instrument (10) according to claim 13, characterized by the fact that the first elongated joint member (910) comprises a plurality of first locking positions corresponding to the various articulated positions and in which the second joint member elongated (930) comprises a plurality of second locking positions corresponding to the plurality of the first locking positions.

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公开号 | 公开日

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BR112013023731A2|2016-12-13|

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AU2012230042A1|2013-09-12|

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US20120234893A1|2012-09-20|

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CN103458809B|2016-03-30|

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EP2685917B1|2019-08-14|

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RU2593358C2|2016-08-10|

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JP2014515636A|2014-07-03|

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CN103458809A|2013-12-18|

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RU2013145914A|2015-04-20|

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WO2012125618A1|2012-09-20|

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EP2685917A1|2014-01-22|

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AU2012230042B2|2016-03-31|

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JP5989686B2|2016-09-07|

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US8857693B2|2014-10-14|

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CA2829810C|2019-03-19|

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CA2829810A1|2012-09-20|

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US11224424B2|2019-08-02|2022-01-18|Covidien Lp|Linear stapling device with vertically movable knife|

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US11123068B2|2019-11-08|2021-09-21|Covidien Lp|Surgical staple cartridge|

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US11109862B2|2019-12-12|2021-09-07|Covidien Lp|Surgical stapling device with flexible shaft|

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US20210186496A1|2019-12-18|2021-06-24|Covidien Lp|Surgical instrument including an adapter assembly and an articulating surgical loading unit|

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US11234698B2|2019-12-19|2022-02-01|Cilag Gmbh International|Stapling system comprising a clamp lockout and a firing lockout|

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US11246593B2|2020-03-06|2022-02-15|Covidien Lp|Staple cartridge|

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US11191537B1|2020-05-12|2021-12-07|Covidien Lp|Stapling device with continuously parallel jaws|

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US11191538B1|2020-06-08|2021-12-07|Covidien Lp|Surgical stapling device with parallel jaw closure|

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US11266402B2|2020-07-30|2022-03-08|Covidien Lp|Sensing curved tip for surgical stapling instruments|

法律状态:
2018-12-18| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2019-10-15| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2020-08-11| B06G| Technical and formal requirements: other requirements [chapter 6.7 patent gazette]|

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2021-03-16| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2021-04-27| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 13/03/2012, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US13/048,566|US8857693B2|2011-03-15|2011-03-15|Surgical instruments with lockable articulating end effector|

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US13/048,566|2011-03-15|

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PCT/US2012/028894|WO2012125618A1|2011-03-15|2012-03-13|Surgical instruments with lockable articulating end effector|

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