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    • 专利摘要:
    ENERGY BASED SCISSOR DEVICE. The present invention relates to an energy-based surgical instrument configured to allow the selective cutting, coagulation and fine dissection required in fine and delicate surgical procedures. The scissor pick instrument provides tube-in-tube construction (60, 70) so that the device is useful for open procedures and minimally invasive procedures. The assembly includes a grab mechanism including a grab arm and / or housing that are configured to create a desired level of tissue grab forces.
    公开号:BR112013024523B1
    申请号:R112013024523-9
    申请日:2012-03-21
    公开日:2021-04-27
    发明作者:Cory G. Kimball；Matthew C. Miller；Nicholas I. Kroscher；Benjamin D. Dickerson；William D. Dannaher
    申请人:Ethicon Endo-Surgery, Inc；
    IPC主号:
    专利说明:

    PRIORITY
    This application claims priority over provisional US patent application Serial No. 61 / 467,180, filed on March 24, 2011, entitled "Ultrasonic Device for Cutting and Coagulating". FIELD OF THE INVENTION
    The present invention relates, in general, to surgical systems and, more particularly, to an energy-based device that is optimized to allow surgeons to perform the cutting, coagulation, and fine dissection required in fine and delicate surgical procedures. in minimally invasive procedures and in open procedures BACKGROUND OF THE INVENTION
    Energy-based surgical instruments are finding an increasing number of applications widely distributed in surgical procedures due to the unique performance characteristics of such instruments. Depending on specific instrument configurations and specific operating parameters, energy-based surgical instruments can provide substantially simultaneously cut and hemostasis by coagulation, desirably minimizing trauma to the patient. The cutting action is typically performed by an end actuator at the distal end of the instrument, which transmits ultrasonic or RF energy to the tissue placed in contact with the end actuator. Instruments of this nature can be configured for use in laparoscopic or endoscopic open surgical procedures, including robotically assisted procedures.
    Energy-based surgical instruments have been developed which include a claw mechanism to attach tissue to an end actuator to attach ultrasonic or RF energy to a patient's tissue. With respect to ultrasonic energy, this arrangement (sometimes called coagulating scissors or ultrasonic transverse cutter) is shown in US Patent Nos. 5,322,055; 5,873,873 and 6,325,811. The surgeon activates the claw arm and presses the claw block against an opposite claw or blade by tightening the grip or handle BRIEF DESCRIPTION OF FIGS.
    The innovative features of the invention are presented with particularity in the appended claims. The invention itself, however, as far as the organization and the methods of operation, can be better understood by reference to the following description, taken in conjunction with the accompanying drawings, in which: Fig. 1A is an exploded view illustrating an expression of an end actuator rotation assembly for an energy-based surgical instrument according to the present invention; Fig. 1B is an exploded view illustrating an alternative tube-in-tube arrangement of the surgical instrument of Fig. 1A according to the present invention; Fig. 2A is a side view of an energy-based surgical instrument of the present invention in the open position; Fig. 2B shows the instrument of Fig. 2A in the closed position; Fig. 2C is a perspective view of a rotation assembly for an energy-based scissor-grip surgical instrument where the instrument is in the closed position; Fig. 2D is a perspective view of the instrument of Fig. 2C in the open position, where the arrows denote the direction of movement; Figs. 3A and 3B illustrate perspective views of an alternative acting member link arrangement according to the present invention; Figs. 4A and 4B illustrate a perspective and side view of an alternative actuating member link arrangement according to the present invention; Fig. 5 is a partial perspective view of a claw arm assembly; Fig. 6 is a perspective view of an alternative link member arrangement; Fig. 7 is a side view of the embodiment of Fig. 6; Fig. 8A is a plan view of a scissor-shaped actuating member having a cylindrical force-modifying fitting in a first position; Fig. 8B represents the actuating member of Fig. 8A with the cylindrical force modifying socket in a second position; Fig. 9A is a side view of an energy-based surgical instrument representing a force-modifying actuation limb lock in a first position; Fig. 9B represents the locking of the actuation member of Fig. 9A in a second position; Figs. 10A to 10D represent side and rear views of an energy-based surgical instrument that employs another expression of a force-modifying member; Figs. 11A to 11C represent a plan view of another expression of a force modifying member; Figs. 12A and 12B represent a side view of another expression of a force modifying member; Figs. 13A through 13D represent another expression of a force-changing member of the acting member; Fig. 14A is a plan view of an end actuator based on energy that employs a sliding channel to modify the clamping force of the end actuator; Fig. 14B represents the end actuator of Fig. 14A in a first clamping position; Fig. 14C represents the end actuator of Fig. 14A in a second clamping position; and DETAILED DESCRIPTION OF THE INVENTION
    Before explaining the present invention in detail, it should be noted that the invention is not limited in its applications or use to the details of construction and arrangement of parts illustrated in the accompanying drawings and description. The illustrative modalities of the invention can be implemented or incorporated into other modalities, variations and modifications, and can be practiced or performed in various ways. In addition, except where otherwise indicated, the terms and expressions used here have been chosen for the purpose of describing the illustrative modalities of the present invention for the convenience of the reader, and are not intended to limit the invention.
    Additionally, it is understood that any one or more of the following modalities described, expressions of modalities, examples, etc. can be combined with any one or more of the other described modalities, expressions of modalities, examples, etc.
    The present invention is particularly directed to an improved energy-based surgical clotting coagulation apparatus, which is configured to result in tissue cutting, coagulation, and / or clamping during surgical procedures, including delicate surgical procedures, both open and minimally invasive procedures. . Its versatile use is facilitated by the selective use of dissection and application of RF or ultrasonic energy. When the RF or ultrasonic components of the device are inactive, the tissue can be readily pinned and manipulated, as desired, without cutting or damaging the tissue. When the RF or ultrasonic components are activated, either separately or together, the device allows the tissue to be pinched for coupling with the energy, to result in tissue coagulation, with increased pressure application, resulting in efficient cutting and coagulation of the tissue. fabric. If desired, ultrasonic energy can be applied to the tissue without using the device's claw mechanism, through proper handling of the ultrasonic blade.
    As will be apparent from the description below, the present coagulator claw apparatus is particularly configured for disposable use due to its simple construction. Thus, it is envisaged that the device will be used in association with an ultrasonic and / or RF generating unit in a surgical system, whereby energy from the generating unit provides the desired performance for the present coagulator claw device. It will be understood that a coagulator claw apparatus incorporating the principles of the present invention can be configured for non-disposable or multiple use, and integrated in a non-separable manner with an associated generating unit. It will also be understood that the present invention can fully contain batteries and the power generator in a cordless manner, as is known and understood in the art. See U.S. Patent Publication No. 2011/0015660, the contents of which are incorporated herein by reference, in their entirety.
    As will become apparent from the description below, the present coagulator claw apparatus provides an alternative method for opening and closing the claw mechanism against the blade, using a tube-in-tube construction. Such a modality can be used in place of existing scissors-like closing mechanisms in such medical devices as presented in U.S. Patent Publication No. 2007/0191713, the contents of which are incorporated herein by reference, in their entirety.
    With reference to Fig. 1A, a first expression of an energy-based surgical instrument 10 is illustrated. The instrument 10 is arranged similarly to a scissors and includes an actuating member 15 that has a thumb ring 20 disposed at the proximal end of the member 15. A pivot assembly is disposed at the distal end of the member 15.
    The energy-based surgical instrument 10 includes a cable assembly composed of multiple parts 50 comprising parts or cable covers 50A, 50B that can be adapted to isolate the operator from, in the case of ultrasonic energy, vibrations from an acoustic set that it can be located inside the housing 50A, 50B. Where instrument 10 employs RF energy, housing 50 can be adapted to isolate the operator from electrical connections therein. The cable assembly 50 can be shaped to be wielded by a user in a conventional scissor arrangement, as will be described here. The proximal end of the cable 50 can be adapted to receive the distal end of an acoustic transducer (not shown). Alternatively, or in combination, cable 50 can be adapted to receive an electrical connection to an RF generator, or it can be adapted to retain a generator and a power supply for ultrasonic and / or cordless RF operation, as is known and skilled in the art.
    The scissor set shown in Figs. 1A and 1B (particularly the cable assembly 50, the actuating member 15, the thumb ring 20, the finger ring 200 and the button 45) can be constructed from a durable plastic, such as polycarbonate or a crystal polymer liquid. It is also contemplated that the scissor set can alternatively be produced from a variety of materials, including other plastics, ceramics or metals. Traditional unloaded thermoplastics, however, have a thermal conductivity of only about 0.20 W / m ° K (Watt / meter- ° Kelvin). In order to optimize the heat dissipation of the instrument, the cable assembly can be constructed from heat conducting thermoplastics, such as highly resistant resins of liquid crystal polymer (LCP), polyphenylene sulfide (PPS), polyetheretherketone (PEEK) and polysulfone, which have a thermal conductivity in the range of 0.2-1 W / cm ° C (20-100 W / m ° K). PEEK resins are thermoplastics charged with aluminum nitride or boron nitride, which are not electrically conductive. The thermally conductive resin helps to control heat within smaller instruments.
    The distal end of the actuating member 15 includes a pivot assembly 25 that engages the annulars 55A, B on the side surface of the housing 50 to allow the scissor action of the actuating member 15. Although shown as separate components 15, 25, it contemplates it is understood that the actuating member 15 and the pivot assembly 25 may be a unitary construction or may comprise sections of different materials. The distal end of the link 30 is pivotally connected to an internal portion of the pivot assembly 25 to facilitate the transfer of force from the actuating member. The proximal end of the link 30 is additionally pivotally connected to the fork 35. The pivoting connection between the pivot assembly 25 and the housing 50 defines an axis 26 around which the actuating member 15 rotates.
    In operation, the actuating member 15 is moved in a direction towards and away from the cable 50, so that it rotates about the axis 26 which, in turn, moves the link 30 in a distal to proximal or proximal to distal (depending on the direction of movement of the acting member 15). The longitudinal movement of the link 30 causes longitudinal translation of the fork 35 along the longitudinal axis 210 of the cable 50, as will be more fully described here.
    The fork 35, in an expression of the instrument 10, has an annular shape and is additionally provided with a central superficial groove 35A. In one expression, the fork 35 partially surrounds the distal end of the transfer link 40, as shown in Figs. 1A and 1B. The central superficial groove 35A of the fork 35 is adapted to receive and radially engage the projection rail 40A of the transfer link 40. The fork 35 and the rail 40A cooperate to allow rotation of the transfer link 40 within the fork 35 and additionally allow the transfer of longitudinal force from link 30 of fork 35 to transfer link 40.
    The transfer link 40 is additionally provided with longitudinal rails or grooves 40B which are adapted to engage longitudinal central surface grooves 45C of the rotation knob 45 (shown as the halves 45A and 45B of the rotation knob). The rails 40B and grooves of the button 45C are adapted to allow axial translation of the transfer link 40 within the rotation button 45, and to allow transfer of the rotational force from the rotation button 45 to the transfer link 40. To provide stability to the rotation button 45 and the transfer link 40, the button 45 is provided with a proximal annular groove 45D on the central surface of the button 45. The groove 45D is adapted to rotate the flanges of the cable 50C in a rotating manner, thus securing the rotation button 45 in a fixed longitudinal position along longitudinal axis 210.
    Still referring to Fig. 1A, the instrument 10 is additionally provided with an end actuator stem assembly 65. In this expression, the stem assembly 65 comprises an outer tube 66 and an inner tube 60 where inner tube 60 is permitted move longitudinally in relation to the outer tube 66.
    The inner tube 60 and the outer tube 66 can be pivotally connected to a claw arm (not shown) at the distal ends of the inner and outer tubes 60, 66. The inner tube 60 is dimensioned to allow the passage of a ultrasonic wave through it, or through an electrode conduit where the instrument 10 uses RF energy. This claw arm that acts on the tube-in-tube arrangement is shown in US Patent Nos. 5,944,737; 5,954,736; 5,980,510 and 6,068,647, the full descriptions being hereby incorporated by reference.
    The inner tube 60 is provided with a depression 75 which is adapted to receive a central projection on the inner surface of the transfer link 40 (not shown), thus allowing the transfer of the axial movement of the transfer link 40 to the inner tube 60. The set of stem 65 is provided with a pin 70 that extends through the openings in outer tube 66 and inner tube 60. In this expression of instrument 10, pin 70 is substantially perpendicular to the longitudinal axis of stem 65. To facilitate longitudinal translation of the tube inner 60 with respect to outer tube 66, the pin openings of inner tube 60 can be elongated longitudinally. When the knob 45 is rotated, the transfer link 40 in turn rotates, rotating the inner tube 60. The rotational force is transferred to the outer tube 66 through pin 70, facilitating the unitary rotation of knob 45 of the transfer link 40 , inner tube 60 and outer tube 66.
    Now with reference to Fig. 1B, a second expression of an energy-based surgical instrument 10 is shown. In this expression, instrument 10 is adapted for use with an ultrasonic acoustic assembly 165. Similar to the previous expression, instrument 10 uses a tube-in-tube construction to activate an end actuator, which can be an ultrasonic claw arm.
    In the expression of Fig. 1B, the claw force is transferred from the pivot assembly 25 to the link 30 and to the fork 35. The fork 35 moves longitudinally, moving the transfer link 40 longitudinally in the manner described above. As shown in Fig. 1B, the transfer link 40 is provided with openings 140A which are adapted to align with openings 170A in the inner tube 170. The pins (not shown) can be inserted in the openings 170A and 140A to join the inner tube 170 to the transfer link 40. Alternatively, the transfer link 40 can be provided with cavities that fit with central projections in the inner tube 170. This coupling allows the transfer of longitudinal force from the fork 35 to the transfer link 40 and to the inner tube 170, thus acting an end actuator.
    The outer tube 180 is provided with proximal flanges 175A and 175B that engage longitudinal grooves (not shown) on the central distal surface of the transfer link 40. The distal central grooves are dimensioned to allow the transfer link 40 to be translated longitudinally to the along the flanges 175A and 175B, and to allow the transfer of the rotational force of the button 45 to the transfer link 40 and to the outer tube 180.
    As shown in Fig. 1B, the acoustic assembly 165 can be provided with a ring and a pin passing through it. The pin is dimensioned to a length greater than the diameter of the waveguide of the acoustic set 165, so that the end portions reside laterally on the side surface of the acoustic set 165. The pin is additionally adapted to traverse the channels on the central surface of the transfer link 40, allowing simultaneous transfer of the rotational force of the button 45 to the inner tube 170, outer tube 180 and acoustic set 165, so that a claw arm (not shown) attached to both inner tube 170 and the outer tube 180 and the ultrasonic blade 165A rotates in a fixed relative position. Such an arrangement is shown in U.S. Patent No. 6,068,647, the full description of which is incorporated herein by reference.
    Figs. 2A and 2B represent the way in which the actuation mechanism described above converts the scissor-like movement of the finger rings 20 and 200 into a lateral movement back and forth of the transfer link 40, along a defined longitudinal axis 210 through the outer tubes 66, 180 and the housing 50. This lateral movement moves the transfer link 40 distally, as shown in Fig. 2A, resulting in opening of the claw arm. Similarly, closing the scissors, as shown in Fig. 2B, results in the transfer link being moved proximally along axis 210, resulting in a closure of the end actuator claw arm. Figs. 2C and 2D show an approximate isometric view of the opening and closing of the instrument 10. The direction of travel of the transfer link 40, link 30 and fork 35, when the actuating member 15 is moved away from the housing 50 (denoted by arrow 250) is denoted by arrow 260 in Fig. 2D.
    In use, a surgeon or operator places the instrument 10 in the palm of your hand. The 10 instrument can be sized to fit comfortably within a variety of adult hand sizes. The instrument 10 can be operated by placing a thumb on the thumb ring 20 and opposing fingers around the housing 50 and / or through the finger ring 200. The opening and closing of the instrument 10 is performed by the surgeon moving the thumb ring in the opposite direction and towards the instrument, respectively. The instrument 10 is additionally adapted for single-handed operation, where the rotation button is placed to allow the surgeon to move the rotation button 45 with the index finger of the hand holding the instrument 10. When held by a surgeon, the side the actuating member 15 of the instrument can be called the top of the instrument, and the cable 50, the bottom of the instrument. The cable 50 can be provided with pressure buttons to allow the activation of energy to an end actuator, with an index or middle finger of the hand that is holding the instrument 10. The pressure buttons can be located proximal to the rotation button 45, on the underside of the cable 50 (the portion of the cable 50 opposite the actuation member 15 denoted by reference number 220) to allow the surgeon to activate the instrument with an index or middle finger. Such modality allows rotation and one-handed activation of an end actuator of the scissor-type closing mechanisms existing in such medical devices, as presented in U.S. patent application 2007/0191713.
    Another expression of the instrument 10 is shown in Figs. 3A and B. In this expression, the pivot axis 300 passes substantially through the longitudinal axis 210 and the link 30 is fixed to an upper portion of the actuating member 15 and is distal to the pivot axis 300. The expression in Fig. 3A a B employs a link 30 and a fork 35 to convert the scissor opening and closing movement of the device into a longitudinal back and forth movement of an inner tube.
    Now with reference to Figs. 4A and 4B, another expression of a force transfer assembly is shown. In this expression, link 30 is placed on the underside of the instrument. The movement of the actuating member 15 around the pivot axis 400 causes the link 30 to translate the fork 35 longitudinally, thus translating the transfer link 40 (not shown) and the inner tube 60 or 170, thus moving an arranged claw on the end actuator. In this arrangement, the link 30 is placed on the bottom side of the cable 50 (towards the operator's little and ring fingers) which can optimize the operator's visibility.
    The link sets shown in Figs. 3 and 4 move the link 30 and the fork 35 in the longitudinal direction opposite to that shown in Figs. 1 to 2, due to the relative locations of the pivot axis and link 30. Fig. 5 represents an arrangement of a tube-in-tube / claw arm arrangement for use with the mechanisms shown in Figs. 3 to 4. As shown, the claw arm 510 is hingedly attached to the outer tube 565 at the hinge joint 500. An inner tube, in mechanical communication with the fork 35 and the transfer link 40, is provided with a U-shaped bracket 520 at its distal end, which is articulated to the claw arm 510 through link 530. In this arrangement, the longitudinal force is transferred from bracket 520 through link 530 to claw arm 510, making with it rotating around the 500A pivot axis. The claw arm assembly of Fig. 5 can be used with the expressions of the instrument 10 shown in Figs. 1 and 2, changing the orientation of the claw arm 510 and bracket 520, as is known and understood in the art.
    Now with reference to Figs. 6 and 7, another expression of a transfer link set is shown. In the expression of Fig. 6, the instrument 10 is provided with two links 630A and 630B that are fixed to the fork 635 on substantially opposite lateral external surfaces. In this arrangement, the links 630A, 630B revolve around the fork 635 on an axis 600A that passes through the longitudinal axis 610 of the instrument 10. This arrangement can have the desired effect of not giving the fork 35 a rotational movement, which it can allow a smoother transfer of the force from the actuation member 15 to the transfer link 40 and internal tubes 60, 170. Although the expression in Fig. 6 represents two links 630A, 630B, it is contemplated that the instrument 10 can only employ a 630A link.
    In the expressions discussed above, the actuation member 15 rotates around a point on the cable 50. It may be desirable to place a lock or fulcrum in the housing 50 that the actuation member 50 engages as the instrument 10 is closed. In one expression, the actuating member 15 comes into contact with the flange 35B of the fork 35 (see Fig. 2B) which prevents the thumb ring 20 from coming into contact with or rubbing against the cable 50. Where the actuating member 15 comprises rigid material, additional depression of the thumb ring 20 towards the housing 50 will give more strength through link 30, fork 35, transfer link 40 and, eventually, to a claw arm on the end actuator of the instrument 10, but may not cause the thumb ring 20 to rub against the cable 50. The ability to apply too much claw pressure to the clamp arm can result in unwanted effects on the tissue when using instrument 10 in an operational procedure. Where the actuating member 15 comprises flexible material, the thumb ring 20 can flex or bend and rub against the housing 50, with the application of more force after contact with the flange 35B. The amount of force applied to the claw arm is partially determined by the location of the fulcrum in relation to the pivot point of the handle of the acting member, as well as the composition and cross section of the acting member 15.
    With reference to Figs. 8A and 8B, an actuating member 15 is shown with a narrow portion 800. In this arrangement, the actuating member 15 can apply less force to the gripper arm, since the portion 800 can flex or bend under smaller loads due to its smaller cross section in relation to other portions of the actuating member 15. When greater claw forces are desired, a collar 810 can be moved to cover portion 800 and avoid flexing or bending, as shown in Fig. 8B. The 810 collar can be selected from a variety of compatible materials for use in a surgery, and must be dimensioned to avoid substantial flexion of the acting member 15 in the 800 portion. It is contemplated that this acting member can be used with any one of the instrument expressions 10 shown above and can also be used in any type of scissor type instrument. It is further contemplated that the narrow portion 800 may not be of the same material as the portions of the actuating member 15 adjacent to the narrow portion 800.
    Figs. 9A and 9B illustrate an alternative expression for modifying the clamping force applied by the actuation member 15. In this expression, the instrument 10 is provided with a lock 900 that can be moved along the longitudinal axis of the cable 50. The lock 900 can travel a groove (not shown) in housing 50 that has multiple holders associated with known clamping forces on the end actuator, where each holder places a lock 900 in different longitudinal positions in relation to the thumb ring 20. As the lock 900 is moved in proximal-to-distal mode, the force conferred by the actuation member 15 increases, where Fig. 9B represents a minimum clamping force and Fig. 9A represents a maximum clamping force, with the thumb ring 20 rubbing against the cable 50.
    Figs. 10A to 10D illustrate another expression of a claw force modification mechanism for use with a scissor-type instrument. The instrument 10 is provided with a cam element 1000 at the proximal end of the housing 50. The cam element 1000 is pivotally attached to the housing 50 to selectively alter the friction point of the thumb ring 20, which, in turn, the amount of clamping force that the actuating member 15 can apply varies. The cam element 1000 and the housing 50 can be provided with holders, so that the cam element 1000 is annularly retained in fixed positions that thus rub against the thumb ring at known locations associated with claw forces. Fig. 12B represents a minimum clamping force arrangement, while Fig. 12D represents a maximum clamping force arrangement. It is further contemplated that the cam element 1000 may be provided with steps or shelves on the side surface of the cam 1000, which fit with the side surface of the thumb ring 20 to allow better engagement between the cam 1000 and the thumb ring 20.
    An alternative expression of the claw force modification mechanism is illustrated in Figs. 11A to C. A locking pin 1100 is controlled by a sliding cam 1110 to selectively engage or disengage locking pin 1100 with thumb ring 20 to increase or decrease the compression forces on an end actuator. Sliding cam 1110 can be manually activated by placing an orthogonally protruding flap (not shown) projecting through housing 50. The flap can be guided into a slot in housing 50, with holders associated with pin heights 1100 known, which are additionally associated with known claw forces. Alternatively, the sliding cam 1110 can be automated to provide a motor and gear assembly that can be controlled by a button or key. Alternatively, the sliding cam 1110 can have more than one cam ramp, as shown in Fig. 11C, to provide varying compressive forces on the end actuator.
    In yet another alternative expression of claw force modification mechanisms, Figs. 12A to B illustrate a locking pin 1200 controlled by a sliding cam 1210 which is pulled by a compressive spring 1220. Sliding cam 1210 and spring 1220 are retained in a channel 1230 of housing 50. In a first state, the pin locking device 1200 engages with thumb ring 20 to limit the compression forces on the end actuator. If the surgeon continues to press the locking pin 1200, the pin 1200 slides down the cam ramp and forces the sliding cam 1210 to be moved proximally in the channel 1230 to compress the spring 1220. The pin 1230 eventually comes into friction with channel 1230, preventing additional movement of pin 1200, as shown in Fig. 12B. With the use of the sliding cam 1210 and the spring 1220, the force response is directed to the surgeon through the pin 1200 in contact with the thumb ring 20. The gradual increase in the force required to compress the spring 1220 can result in compressive forces greater variability in an end actuator.
    The thumb ring 20 can be provided with a movable locking pin to selectively change the clamping force of the end actuator, as shown in Figs. 13A to D. The 1300 locking pin is slidably mounted on the lower lateral surface of the thumb ring 20. In operation, a surgeon may want more clamping force than is available when the 1300 locking pin is in a more upright position. distal, as shown in Fig. 13A. To selectively rotate or move locking pin 1300 from a more distal position, shown in Figs. 13B and 13C, the thumb ring can be placed in contact with or rub against the cable 50, as shown in Fig. 13D. Lock pin 1300, in one expression, can be driven by a groove (not shown) provided in a lower portion of thumb ring 20. While shown to be substantially rectangular, lock pin 1300 can be round to provide a cam surface, and the thumb ring 20 can be provided with detectors in the channel of the locking pin 1300, as is known and understood in the art, to allow selective movement of the locking pin 1300, additionally allowing selective engagement between its cam surface and cable 50, thereby incrementally changing the claw force of the end actuator.
    In yet another alternative expression of a claw force modification mechanism, Figs. 14A to C illustrate an enlarged pivot slot where the pivot point on the actuating member can be lengthened or shortened to alter the movement of the arm between the actuating member and the cable, and thus the compressive forces on the end actuator .
    In the expression in Fig. 14, the actuating member 1315 is equipped with circular devices 1335 and 1340. As shown, the spokes of the openings 1335 and 1340 overlap, creating an enlarged pivot slot 1345 in the claw arm 1315. A rivet 1330 it is located normal to the stem axis of the end actuator 1300. The rivet 1330 is shaped to allow movement of the pivot point of the claw arm 1315 between opening 1335 and 1340. As shown, rivet 1330 is oval, but other shapes are contemplated depending on the configuration of the pivot slot 1345. In a first position, the actuating member is moved to allow the opening 1340 to engage and rotate around the rivet 1330, as shown in Fig. 14B. This first position creates a first compressive force between the end actuator 1325 and the jaw 1350. In a second position, the jaw arm is moved to allow the pivot slot 1345 to be moved in relation to the rivet 1330, and to additionally allow rivet 1330 to be engaged with opening 1335, thereby creating a second force between end actuator 1325 and claw arm 1350, as shown in Fig. 14C. This arrangement can be used with the instrument 10 previously discussed, using a pivot slot 1345 on both sides of the pivot assembly 25 and, in addition, providing rivets 1330 on the side surfaces of the housing 50 to engage pivot slits 1345 .
    Although the present invention has been illustrated by describing various modalities, it is not the applicant's intention to restrict or limit the spirit and scope of the claims attached to these details. Numerous variations, changes, and substitutions will occur for those skilled in the art, without departing from the scope of the invention. In addition, the structure of each element associated with the present invention can alternatively be described as a means of providing the function performed by the element.
    Having shown and described various modalities and examples of the present invention, further adaptations of the methods and devices described herein can be carried out by means of suitable modifications by the element skilled in the art without departing from the scope of the present invention. Several potential modifications have been mentioned and others will be effective for those skilled in the art. For example, the specific materials, dimensions and scale of the drawings will be understood as non-limiting examples. It is further understood that the various expressions described herein can be combined with one another, as is known and understood in the art. Consequently, the scope of the present invention should be considered in terms of the following claims and is understood to be not limited to the details of structure, materials or acts presented and described in the specification and drawings.
    权利要求:
    Claims (12)
    [0001]
    1. Surgical instrument comprising: an external hollow tube (66,180) defining a longitudinal axis (210); a claw arm (510) hingedly connected to the outer tube (66,180); an inner tube (60,170) disposed inside the outer tube (66,180), the inner tube (60,170) being hingedly connected to the claw arm (510) and sliding longitudinally in relation to the outer tube (66,180); a cable (50) having a proximal end and a distal end disposed along the longitudinal axis; an actuating member (15) mounted articulated to the cable (50); a link arm (30) articulated to the actuating member (15); a fork (35) hingedly attached to the link arm (30); and a transfer link (40) disposed around the longitudinal axis (210) at the distal end of the cable (50), the transfer link (40) being slidable longitudinally in relation to the cable (50) and longitudinally engaging the fork (35 ), the transfer link (40) being fixedly fixed to the inner tube (60,170); characterized by the fact that it still comprises a rotation button (45) rotatingly engaging the transfer link (40), so that the rotation of the rotation button (45) causes the transfer link (40) to rotate, after which the rotation of the transfer link (40) causes the inner tube (60,170) to rotate; and in which the rotation button (45), the transfer link (40), the inner tube (60,170) and the outer tube (66,180) are configured to rotate in a unitary manner.
    [0002]
    2. Instrument according to claim 1, characterized by the fact that the transfer link (40) comprises a cylinder having a central annular surface and a lateral annular surface.
    [0003]
    3. Instrument according to claim 2, characterized by the fact that it still comprises at least one rail (40B) that extends longitudinally on the lateral surface of the transfer link.
    [0004]
    4. Instrument according to claim 3, characterized by the fact that it still comprises a rotation button (45) partially arranged around the lateral annular surface of the transfer link and the rotation button (45) has at least one recess central longitudinal (45C) that fits with at least one rail of the transfer link (40B).
    [0005]
    5. Instrument, according to claim 4, characterized by the fact that the transfer link (40) still comprises a projection rail (40A) disposed annularly around the distal end of the transfer link.
    [0006]
    6. Instrument, according to claim 5, characterized by the fact that the fork (35) has an annular recess (35A) that fits with the projection rail (40A) of the transfer link arranged annularly.
    [0007]
    7. Instrument according to claim 6, characterized by the fact that it still comprises a finger ring (200) disposed on the proximal end of the cable.
    [0008]
    8. Instrument, according to claim 7, characterized by the fact that it still comprises a thumb ring (20) disposed on the proximal end of the actuating member.
    [0009]
    9. Instrument according to claim 8, characterized in that the proximal end of the cable is provided with a means for selectively engaging the thumb ring (20).
    [0010]
    10. Instrument, according to claim 8, characterized by the fact that it still comprises a locking pin (1300) slidably attached to the thumb ring (20), in which the locking pin (1300) selectively engages the cable (50).
    [0011]
    11. Instrument according to claim 1, characterized by the fact that: the handle (50) has a lateral surface and a rivet (1330) disposed on the lateral surface; an actuating member (15) has a pivot slot (1345) engaging the cable rivet (1330) in an articulated manner;
    [0012]
    12. Instrument, according to claim 11, characterized by the fact that the pivot slot (1345) is comprised of two circular openings (1335,1340) with overlapping rays.
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    同族专利:
    公开号 | 公开日
    EP2688496B1|2019-07-24|
    US8974447B2|2015-03-10|
    JP6067670B2|2017-01-25|
    BR112013024523A2|2020-09-29|
    JP2014516270A|2014-07-10|
    EP2688496A2|2014-01-29|
    WO2012129292A3|2013-01-24|
    WO2012129292A2|2012-09-27|
    US20120245582A1|2012-09-27|
    EP2688496B8|2019-09-11|
    CN103747752B|2017-04-26|
    CN103747752A|2014-04-23|
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    法律状态:
    2020-10-20| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2020-10-27| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2021-02-23| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    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 21/03/2012, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US201161467180P| true| 2011-03-24|2011-03-24|
    US61/467,180|2011-03-24|
    PCT/US2012/029924|WO2012129292A2|2011-03-24|2012-03-21|Energy-based scissors device|
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