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WO2016169039A1 - Raccord jetable à utiliser avec un dispositif séparateur d'obturation de vaisseaux réutilisable - Google Patents

Raccord jetable à utiliser avec un dispositif séparateur d'obturation de vaisseaux réutilisable Download PDF

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Publication number
WO2016169039A1
WO2016169039A1 PCT/CN2015/077340 CN2015077340W WO2016169039A1 WO 2016169039 A1 WO2016169039 A1 WO 2016169039A1 CN 2015077340 W CN2015077340 W CN 2015077340W WO 2016169039 A1 WO2016169039 A1 WO 2016169039A1
Authority
WO
WIPO (PCT)
Prior art keywords
connector assembly
housing
electrosurgical instrument
members
handle
Prior art date
Application number
PCT/CN2015/077340
Other languages
English (en)
Inventor
Weijiang Ding
Yuanxun Li
Kai Liu
Jianjiang Chen
Original Assignee
Covidien Lp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covidien Lp filed Critical Covidien Lp
Priority to PCT/CN2015/077340 priority Critical patent/WO2016169039A1/fr
Priority to CN201610256036.5A priority patent/CN106063723B/zh
Priority to CN201620345785.0U priority patent/CN205885519U/zh
Publication of WO2016169039A1 publication Critical patent/WO2016169039A1/fr

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B34/35Surgical robots for telesurgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B34/37Master-slave robots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0023Surgical instruments, devices or methods, e.g. tourniquets disposable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00172Connectors and adapters therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00404Blood vessels other than those in or around the heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589Coagulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00595Cauterization
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601Cutting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063Sealing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/0091Handpieces of the surgical instrument or device
    • A61B2018/00916Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B2018/1452Probes having pivoting end effectors, e.g. forceps including means for cutting
    • A61B2018/1457Probes having pivoting end effectors, e.g. forceps including means for cutting having opposing blades cutting tissue grasped by the jaws, i.e. combined scissors and pliers

Definitions

  • the present disclosure relates to energy-based surgical instruments and, more particularly, to energy-based surgical forceps configured for treating and/or cutting tissue.
  • a forceps or hemostat is a plier-like instrument which relies on mechanical action between its jaws to grasp, clamp, and constrict tissue.
  • Energy-based forceps utilize both mechanical clamping action and energy, e.g., electrosurgical energy, ultrasonic energy, light energy, microwave energy, heat, etc., to affect hemostasis by heating tissue to coagulate and/or cauterize tissue.
  • Certain surgical procedures require more than simply cauterizing tissue and rely on the unique combination of clamping pressure, precise energy control, and gap distance (i.e., distance between opposing jaws when closed about tissue) to “seal” tissue.
  • the surgeon has to accurately sever the tissue along the newly formed tissue seal.
  • many tissue sealing instruments have been designed to incorporate a blade that is movable with respect to a blade slot disposed in a jaw of the tissue sealing instrument to sever the tissue after forming a tissue seal.
  • Tissue sealing instruments that include a blade and blade slot, however, are typically single-use devices as the blade and blade slot may be difficult to clean, and the blade may wear and dull with repeated use.
  • the incorporation of a blade slot into a jaw of a tissue sealing instrument may reduce the sealing strength of the jaw, and the width of the blade slot may increase the width of the jaw which, in turn, may result in a reduction in the dissection capabilities of the tissue sealing instrument.
  • the present disclosure is directed to reusable energy-based surgical instruments having disposable connector assemblies.
  • the reusable energy-based surgical instruments include movable, opposed jaw members that are configured for fine dissection, sealing, and/or cutting without the use of a blade and slot jaw configuration.
  • an electrosurgical instrument includes reusable first and second elongated shaft members, and a disposable connector assembly.
  • the first elongated shaft member includes a proximal end portion having a first handle member and a distal end portion including a first jaw member
  • the second elongated shaft member includes a proximal end having a second handle member and a distal end portion including a second jaw member.
  • the first and second jaw members include first and second tissue contacting surfaces, respectively, and each of the first and second tissue contacting surfaces has a sealing surface and a cutting edge.
  • At least one of the first and second handle members is movable relative to the other about substantially orthogonal axes to move the first and second jaw members between an open position, a sealing position, and a cutting position.
  • the connector assembly includes a housing selectively engageable with at least one of the shaft members. The connector assembly is configured to communicate electrosurgical energy between the first and second tissue contacting surfaces when the first and second jaw members are disposed in the sealing position.
  • the electrosurgical instrument includes a raised rail disposed on an inner surface of the second handle member.
  • the raised rail is configured to engage a lower surface of the housing of the connector assembly.
  • the raised rail includes a recess defined therein and the connector assembly includes a fastening clamp extending through the lower surface of the housing that is configured to engage the recess.
  • the connector assembly includes clamp caps operatively connected to the fastening clamp. The clamp caps are movable to a depressed position to move the fastening clamp out of engagement with the recess of the raised rail.
  • the electrosurgical instrument includes a tail extending proximally from the second handle member.
  • the tail is configured to be received within a slot defined in the housing of the connector assembly.
  • the electrosurgical instrument includes a bump stopper disposed on an inner surface of the first handle member and a plunger extending through an upper surface of the housing of the connector assembly.
  • the bump stopper is configured to engage the plunger when the first and second handle members are disposed in the sealing position.
  • the plunger includes a first electrical contact disposed on a top portion thereof that is configured to engage the bump stopper.
  • the plunger is movable in and out of contact with a switch disposed within the housing of the connector assembly.
  • the switch includes a pin diode.
  • the connector assembly includes a second electrical contact disposed within the housing that is configured to contact the second handle member.
  • the electrosurgical instrument includes a nose portion extending from an inner surfaces of the first handle member towards the second handle member and a first electrical contact disposed in an upper surface of the housing of the connector assembly.
  • the nose portion is aligned with the first electrical contact and configured to engage the first electrical contact when the first and second handle members are disposed in the sealing position.
  • the connector assembly includes a switch extending through an upper surface of the housing. The switch is configured to be depressed by the inner surface of the first handle member when the first and second handle members are disposed in the sealing position.
  • the electrosurgical instrument includes a guide member disposed on the first shaft member and a slot defined in a distal end of the housing of the connector assembly.
  • the guide member is configured to slide within the slot when the first and second handle members are moved between the open and sealing positions.
  • the distal end of the housing of the connector assembly includes a lip.
  • the guide member is configured to slide under the lip when the first and second handle members are moved between the sealing and cutting positions.
  • the connector assembly includes a second electrical contact disposed within a proximal end of the housing that is configured to contact the second handle member.
  • the second electrical contact is a resilient member that imparts an elastic force against the second handle member.
  • first and second tissue contacting surfaces are upper surfaces of first and second removable electrodes, respectively.
  • first and second electrodes include lower surfaces that frictionally engage inner surfaces of the first and second jaw members.
  • the first and second electrodes are electrically connected to a switch disposed in the housing of the connector assembly.
  • the first shaft member includes a bumper disposed on an inner surface thereof that is configured to depress the switch when the first and second handle members are disposed in the sealing position.
  • FIG. 1 is a side, perspective view of an open, assembled electrosurgical instrument including a forceps and a connector assembly in accordance with the present disclosure
  • FIG. 2 is a side, perspective view of the electrosurgical instrument of FIG. 1 in a disassembled state in accordance with the present disclosure
  • FIG. 3 is a perspective view of the forceps of FIG. 1 with parts separated;
  • FIG. 4 is an enlarged, front perspective view of a distal end portion of the forceps of FIG. 1;
  • FIG. 5 is a perspective view of the connector assembly of FIG. 1 with parts separated;
  • FIG. 6A is a side, perspective view of the electrosurgical instrument of FIG. 1 in a sealing position
  • FIG. 6B is an enlarged, perspective view of a portion of the electrosurgical instrument of FIG. 6A, shown along the area of detail 6B in FIG. 6A;
  • FIG. 6C is a cross-sectional view of the forceps of FIG. 6A taken along line 6C-6C of FIG. 6A;
  • FIG. 7A is a side, perspective view of the electrosurgical instrument of FIG. 1 in a cutting position
  • FIG. 7B is an enlarged, perspective view of a portion of the electrosurgical instrument of FIG. 7A, shown along the area of detail 7B in FIG. 7A;
  • FIG. 7C is a cross-sectional view of the forceps of FIG. 7A taken along line 7C-7C of FIG. 7A;
  • FIG. 8 is a side, perspective view of an open, assembled electrosurgical instrument including a forceps and a connector assembly in accordance with the present disclosure
  • FIG. 9 is a side, perspective view of the electrosurgical instrument of FIG. 8 in a disassembled state in accordance with the present disclosure
  • FIG. 10 is a perspective view of the connector assembly of FIG. 8 with parts separated;
  • FIG. 11A is a side perspective view of the electrosurgical instrument of FIG. 8 in an open position, with a half of a housing of the connector assembly removed;
  • FIG. 11B is an enlarged, perspective view of a portion of the electrosurgical instrument of FIG. 11A, shown along the area of detail 11 B identified in FIG. 11A;
  • FIG. 12A is a side perspective view of the electrosurgical instrument of FIG. 8 in a sealing position, with a half of a housing of the connector assembly removed;
  • FIG. 12B is an enlarged, perspective view of a portion of the electrosurgical instrument of FIG. 12A, shown along the area of detail 12B identified in FIG. 12A;
  • FIG. 13A is a side perspective view of the electrosurgical instrument of FIG. 8 in a cutting position, with a half of a housing of the connector assembly removed;
  • FIG. 13B is an enlarged, perspective view of a portion of the electrosurgical instrument of FIG. 13A, shown along the area of detail 13B identified in FIG. 13A;
  • FIG. 14A is a side, perspective view of an open, assembled electrosurgical instrument including a forceps and a connector assembly in accordance with the present disclosure
  • FIG. 14B is a side, perspective view of the electrosurgical instrument of FIG. 14A with a half of a housing of the connector assembly removed;
  • FIG. 14C is an enlarged, perspective view of a portion of the forceps of FIG. 14A, shown along the area of detail 14C identified in FIG. 14A;
  • FIG. 15 is a schematic illustration of a work station configured for use with an electrosurgical instrument of the present disclosure.
  • proximal refers to a portion of a structure closer to an operator
  • distal refers to a portion of the same structure further from the operator.
  • subject refers to a human patient or animal.
  • doctor refers to a doctor (e.g., a surgeon) , a nurse, and other clinicians or care providers, and may include support personnel.
  • doctor e.g., a surgeon
  • nurse e.g., a nurse
  • other clinicians or care providers e.g., a patient or animal
  • the terms “generally, ” “substantially, ” and “about” shall be understood as words of approximation that take into account relatively little to no variation in the modified term (s) .
  • an energy-based surgical instrument 1 in accordance with the present disclosure is configured for grasping, electrically treating, and mechanically dissecting tissue or vessels in open and/or laparoscopic surgical procedures.
  • the energy-based surgical instrument 1 includes a reusable forceps 100 having a connector assembly 200 that is disposable and removably attachable to the forceps 100.
  • the connector assembly 200 is releasably connected to an electrosurgical energy source (not shown) via a cable 201 terminating at a plug 201a.
  • the connector assembly 200 may be reusable.
  • the forceps 100 include first and second elongated shaft members 110 and 120.
  • the first elongated shaft member 110 includes proximal and distal end portions 112 and 114, respectively, and the second elongated shaft member 120 includes proximal and distal end portions 122 and 124, respectively.
  • the proximal end portions 112 and 122 of the first and second shaft members 110 and 120 are first and second handle members 130 and 140, respectively.
  • the first and second handle members 130 and 140 are configured to allow an operator to effect movement of one or both of the first and second shaft members 110 and 120 relative to the other.
  • the distal end portions 114 and 124 of the first and second shaft members 110 and 120 cooperate to define an end effector assembly 115 having opposed first and second jaw members 150 and 160.
  • the first and second handle members 130 and 140 each define a finger hole 130a and 140a, respectively, therethrough for receiving a finger of an operator.
  • the finger holes 130a and 140a facilitate movement of the first and second handle members 130 and 140 relative to each other.
  • the first and second handle members 130 and 140 are each monolithically formed with respective shaft members 110 and 120.
  • the first and second handle members 130 and 140 may each be engaged with respective shaft members 110 and 120 in any suitable configuration, e.g., via mechanical engagement, molding, adhesion, etc.
  • the first shaft member 130 includes a bumper 132 extending from an inner surface 130b of the first handle member 130 towards the second handle member 140.
  • the second handle member 140 includes an inner surface 140b including a raised rail 142 configured to matingly engage the connector assembly 200.
  • the raised rail 142 includes a recess 142a defined therein that is configured to receive a fastening clamp of the connector assembly 200 for securing the connector assembly 200 to the second handle member 140.
  • the second handle member 140 includes a proximally extending tail 144 configured to engage the connector assembly 200 and to limit distal movement of the connector assembly 200 to ensure proper positioning of the connector assembly 200 on the forceps 100.
  • the first shaft member 110 intersects the second shaft member 120 at intersection portions 116 and 126 of the first and second shaft members 110 and 120, respectively.
  • a pivot pin 170 is positioned through openings 116a and 126a defined in the intersection portions 116 and 126 of the first and second shaft members 110 and 120 such that movement of the first and second handle members 130 and 140 effect corresponding movement of the first and second jaw members 150 and 160 relative to each other.
  • the intersection portions 116 and 126 respectively, include substantially flat inner proximal portions 116b and 126b, and contoured inner distal portions 116c and 126c including complementary convex and concave surfaces. It should be understood that the intersection portions 116 and 126 may be constructed as shown, or in reverse so that the intersection portions 116 and 126 include concave and convex surfaces, respectively.
  • the flat inner proximal portions 116b and 126b ensure that the first and second shaft members 110 and 120 rotate about an “x” axis (FIG. 6A) when moving the first and second shaft members 110 and 120 from an open position to a first approximated sealing position.
  • contoured distal portions 116c and 126c allow at least one of the first and second shaft members 110 and 120 to move about a “y” axis (FIG. 7A) , that is substantially perpendicular to the “x” axis, when moving the first and second shaft members 110 and 120 from the first approximated sealing position to a second approximated cutting position.
  • the pivot pin 170 includes a substantially semispherical head 172 disposed in the opening 116a of the first shaft member 110 and a cylindrical shaft 174 extending through the opening 126a defined in the second shaft member 120 such that the second shaft member 120 pivots about the cylindrical shaft 174 about the “x” axis and the first shaft member 110 is pivotable about the semispherical head 172 about the “x” and “y” axes.
  • first and second jaw members 150 and 160 extend distally from the intersection portions 116 and 126 of the first and second shaft members 110 and 120.
  • Proximal portions 150a and 160a of the first and second jaw members 150 and 160 extend longitudinally from the intersection portions 116 and 126 of the forceps 100.
  • Distal portions 150b and 160b of the first and second jaw members 150 and 160 curve away from the proximal portions 150a and 160a and include first and second tissue contacting surfaces 152 and 162 that are opposed to one another.
  • the first and second tissue contacting surfaces 152 and 162 of the first and second jaw members 150 and 160 define complementary stepped surfaces which together seal and/or cut tissue disposed therebetween.
  • the first tissue contacting surface 152 includes a lower, base surface 152a and an upper, raised surface 152b that are laterally disposed relative to each other, which together define a sealing surface.
  • An intermediate wall 152c extends perpendicular to, and connects, the base and raised surfaces 152a and 152b.
  • a cutting edge 152d is formed at the intersection of the raised surface 152b and the intermediate wall 152c.
  • the second tissue contacting surface 162 includes a lower base surface 162a laterally disposed relative to an upper, raised surface 162b, and an intermediate wall 162c extending between and connecting the base and raised surfaces 162a and 162b.
  • a cutting edge 162d is disposed at the intersection of the raised surface 162b and the intermediate wall 162c.
  • the forceps 100 is formed of a conductive material, such as a metal, and includes an electrically insulative coating disposed over the forceps 100, except at the tissue contacting surfaces 152 and 162 of the first and second jaw members 150 and 160, the bump stopper 132 of the first handle member 130, and the tail 144 of the second handle member 140. Accordingly, the tissue contacting surfaces 152 and 162, the bump stopper 132, and the tail 144 are not coated with an insulative material and are electrically conductive.
  • the connector assembly 200 includes a housing 202 including a pair of housing halves 202a and 202b configured to matingly engage each other.
  • the housing 202 includes a lower surface 202c configured to engage the raised rail 142 of the second handle member 140.
  • the lower surface 202c extends proximally into a slot 202d configured to receive the tail 144 of the second handle member 140.
  • the lower surface 202c may be contoured for ergonomic fit with a finger of an operator positioned through the finger hole 140a of the second handle member 140.
  • a fastening clamp 204 is secured within the housing 202 by first and second clamp caps 204a and 204b.
  • the fastening clamp 204 is biased outwardly such that a bottom portion 204c of the fastening clamp 204 extends through the lower surface 202c of the housing 202 to engage the recess 142a defined in the raised rail 142 and lock the connector assembly 200 onto the second shaft member 120.
  • a plunger 208 is disposed within the housing 202 with a top portion 208a of the plunger 208 extending through an upper surface 202e of the housing 202 in general alignment with the bump stopper 132 of the first handle member 130.
  • the top portion 208a of the plunger 208 includes a first electrical contact 210 that is configured to mate and be contacted by the bumper 132 of the first handle member 130.
  • a lower portion 208b of the plunger 208 is in general alignment with a switch 212 to route electrical signals, such as radio frequency (RF) signals, between an electrosurgical energy source (not shown) and the forceps 100.
  • Switch 212 includes a pin diode 214 including, for example, RF pins 212a and 212b and a signal pin 212c.
  • Wires 216 and 218 extend from the RF pins 212a and 212b and out through a proximal end 202f of the housing 202 within the cable 201 for electrically connecting the forceps 100 to the electrosurgical energy source (not shown) .
  • a single wire coupled to both RF pins 212a and 212b and extending therefrom may alternatively be provided in place of wires 216 and 218.
  • a second electrical contact 220 is attached to the lower surface 202c of the housing 202 and extends into the slot 202d such that the second electrical contact 220 contacts the tail 144 of the second handle member 140 when the connector 200 is assembled onto the forceps 100.
  • a wire 222 electrically connects the second contact member 220 to the electrosurgical energy source (not shown) through cable 201.
  • the lower surface 202c of the housing 202 of the connector assembly 200 is aligned with the raised rail 142 of the second handle member 140 when the forceps 100 are in an open position.
  • the housing 202 is slid, from distally in the direction of arrow “A, ” along the raised rail 142 until the tail 144 of the second handle member 140 is received by the slot 202d (FIG. 5) of the connector assembly 200 and the fastening clamp 204 (FIG. 5) engages the recess 142a defined in the raised rail 142.
  • the fastening clamp 204 is biased to automatically lock into the recess 142a upon assembly.
  • the forceps 100 is placed at a desired surgical site around desired tissue and/or vessel (s) .
  • the first and second handle members 130 and 140 are approximated by moving at least one of the first and second handle members 130 and 140 towards the other such that the first and second handle members 130 and 140 pivot with respect to the other about the pivot pin 170 about the “x” axis to grasp tissue between the first and second jaw members 150 and 160.
  • first and second handle members 130 and 140 are brought together in a first, approximated sealing position, as shown in FIGS.
  • the bump stopper 132 contacts the first electrical contact 210 disposed within the plunger 208 and depresses the plunger 208 into contact with the switch panel 212 to close the electrical circuit and energize the tissue contacting surfaces 152 and 162 of the first and second jaw members 150 and 160 to seal tissue disposed therebetween.
  • the first and second tissue contacting surfaces 152 and 162 are approximated and diametrically opposed to one another such that the base surface 152a of the first jaw member 150 is aligned with the raised surface 162b of the second jaw member 160 and the raised surface 152b of the first jaw member 150 is aligned with the base surface 162a of the second jaw member 160. Sealing is effected, for example, by the application of pressure on tissue disposed between the first and second tissue contacting surfaces 152 and 162, and the electrosurgical energy transferred from the electrosurgical energy source (not shown) .
  • the first and second handle members 130 and 140 may be returned to the open position to release the tissue or may be moved to a second, approximated cutting position to cut the tissue disposed between the first and second jaw members 150 and 160. As shown in FIGS. 7A-7C, to move to the second approximated cutting position, the first handle member 130 is moved laterally such that it rotates about the “y” axis and the bump stopper 132 disengages from the first electrical contact 210.
  • Cutting is effected, for example, by the application of pressure on tissue disposed between the first and second tissue contacting surfaces 152 and 162, and lateral movement of the cutting edges 152d and 162d of the first and second tissue contacting surfaces 152 and 162 with respect to each other upon lateral movement of the first handle member 130 relative to the second handle member 140.
  • the first and second tissue contacting surfaces 152 and 162 are laterally offset from one another such that the raised surfaces 152b and 162b of the first and second jaw members 150 and 160 are aligned with each other.
  • the operator presses the clamp caps 204a and 204b of the housing 202 to move the fastening clamp 204 out of the recess 142a defined in the raised rail 142, and then slides the connector assembly 200 proximally away from the second handle member 140.
  • the forceps 100 may then be sterilized for re-use, and the connector assembly 200 may be disposed.
  • Forceps 100 includes a first elongated shaft member 110’ pivotably connected to a second elongated shaft member 120’ via a pivot pin 170.
  • the first and second elongated shaft members 110’ and 120’ include first and second handle memhers 130’ and 140’ , intersection portions 116 and 126, and first and second jaw members 150 and 160.
  • a nose portion 134 extends from an inner surface 130b’ of the first handle member 130’ and a guide member 136 extends from an inner surface 110a of the first shaft member 110’ .
  • the guide member 136 includes a body portion 136a extending generally vertically towards the second shaft member 120’ and a leg portion 136b extending substantially perpendicularly from the body portion 136a such that the body portion 136a and the leg portion 136b have a general L-shaped configuration and define a gap 136c between the inner surface 130b’ of the first handle member 130’ and the leg portion 136b of the guide member 136.
  • the leg portion 136b is generally aligned with a distal end of the connector assembly 200’ .
  • a raised rail 142’ extends from an inner surface 140b’ of the second handle member 140’ and a tail 144’ extends proximally from the second handle member 140' .
  • a recess 142a' is defined between the raised rail 142' and the tail 144' .
  • the connector assembly 200' includes a housing 202' including a pair of housing halves 202a' and 202b' configured to matingly engage each other.
  • the housing 202' includes a lower surface 202c' configured to engage the raised rail 142' of the second handle member 140' .
  • a fastening clamp 204 is secured within the housing 202' by first and second clamp caps 204a and 204b with a bottom portion 204a of the fastening clamp 204 extending through the lower surface 202c' of the housing 202' to engage the recess 142a' defined between the raised rail 142' and the tail 144' to lock the connector assembly 200' onto the second shaft member 120' .
  • a switch 208' is disposed within the housing 202' with a top portion 208a' of the switch 208' extending through an upper surface 202e' of the housing 202' in general alignment with the inner surface 130b' of the first handle member 130' .
  • a first electrical contact 210' is disposed distal to the switch 208' and is configured to mate with the nose portion 134 of the first handle member 130' when the first and second handle members 130' and 140' are positioned in the first approximated seal position.
  • a distal end 202g of the housing includes a slot 202h configured to receive the leg portion 136b of the guide member 136 of the first handle member 130' when the first and second handle members 130' and 140' are moved between the open and first approximated sealing positions.
  • the distal end 202g of the housing 202' also includes a lip 202i configured to receive the leg portion 136b thereunder when the first handle member 130' is moved between the first approximated sealing position and the second approximated cutting position.
  • One or more wires 216’ and 218’ extend from the switch 208' and the first electrical contact 210' , respectively, and out through the proximal end 202f' of the housing 202' within the cable 201 for electrically connection to an electrosurgical energy source (not shown) .
  • a second electrical contact 220’ which is a resilient member, is attached to the proximal end 202f' of the housing 202' and is configured to contact the tail 144' of the second handle member 140' when assembled to the forceps 100' .
  • a wire 222' extends from second contact member 220' and out through the proximal end 202f' of the housing 202' within the cable 201 for electrical connection to the electrosurgical energy source (not shown) .
  • the forceps 100' is assembled and disassembled with the connector assembly 200' in substantially the same manner as described above with respect to the forceps 100 and the connector assembly 200.
  • the second electrical contact 220' is configured to provide an elastic force against the tail 144' of the second handle member 140' to ensure proper assembly and to aid in release of the connector assembly 200' from the forceps 100' .
  • the forceps 100' is placed at a desired surgical site and the first and second jaw members 150 and 160 are positioned in an open position around desired tissue and/or vessel (s) , as shown in FIGS. 11A and 11B.
  • the first and second handle members 130’ and 140’ are approximated by moving one or both of the first and second handle members 130' and 140 towards the other such that the first and second handle members 130' and 140 pivot with respect to the other about the pivot pin 170 about the “x” axis.
  • the first and second handle memhers 130' and 140' are brought together in this first, approximated sealing position, as shown in FIGS.
  • the slot 202h of the housing 202' guides movement of the leg portion 136b about the “x” axis, the nose portion 134 contacts the first electrical contact 210' , and the inner surface 130b' of the first handle member 130' depresses the switch 208' to close the electrical circuit and energize the tissue contacting surfaces 152 and 162 (FIG. 11A) of the first and second jaw members 150 and 160 to seal tissue disposed therebetween.
  • the first and second handle members 130' and 140' may be returned to the open position to release tissue held therebetween or may be moved to a second, approximated cutting position to cut the tissue disposed between the first and second jaw members 150 and 160.
  • the first and second handle members 130' and 140' are released to open a small angle and disconnect the nose portion 134 from the first electrical contact 210' so that the electrical circuit is open and disconnected.
  • the first handle member 130' is then moved laterally and rotated about the “y’ axis such that the leg portion 136b moves under the lip 202i (FIG.
  • first and second jaw members 150 and 160 laterally move relative to each other to cut tissue disposed between the first and second tissue contacting surfaces 152 and 162 via the cutting edges 152d and 162d, as described above.
  • the energy-based surgical instrument 3 includes a forceps 300 and a connector assembly 400 releasably connectable to an electrosurgical energy source (not shown) via cable 401 and plug 401a.
  • the connector assembly 400 includes removable electrodes 410 and 420 connected to a housing 402 of the connector assembly 400 via cables 403 and 405.
  • the forceps 300 includes a first elongated shaft member 310 coupled to a second elongated shaft member 320 via a pivot pin 170.
  • the first and second elongated shaft members 310 and 320 define an end effector 315.
  • the first elongated shaft member 310 includes a first handle member 330, an intersection portion 116, and a first jaw member 350.
  • a bumper 321 is disposed on an inner surface 330a of the first shaft member 310 and extends towards the second shaft member 320.
  • the second elongated shaft member 320 includes a second handle member 340, an intersection portion 126, and a second jaw member 360.
  • the first and second handle members 330 and 340 include first and second guide members 332 and 342, respectively.
  • the first and second guide members 332 and 342 are disposed on the first and second handle members 330 and 340 with body portions 332a and 342a of the first and second guide members 332 and 342 longitudinally offset and laterally spaced with respect to one another and leg portions 332b and 342b aligned such that substantially flat inner surfaces of the leg portions 332b and 342b slide past one another upon movement of the first and second handle members 330 and 340 between the open position and the first approximated position.
  • Substantially flat bottom surfaces 332c and 342c of the first and second guide members 332 and 334 slide past one another upon movement of the first and second handle members 330 and 340 between the first and second approximated position.
  • Protrusive outer surfaces 332d and 342d of the first and second guide members 332 and 342 prevent misalignment of the first and second handle members 330 and 340.
  • the first and second jaw members 350 and 360 include elongated proximal portions 350a and 360a extending from the intersection portions 116 and 126 of the first and second shaft members 310 and 320.
  • the first and second jaw members 350 and 360 include distal portions 350b and 360b, respectively, including inner surfaces 356 and 366 configured to receive electrodes 410 and 420 of the connector assembly 400.
  • the connector assembly 400 includes a housing 402 having a pair of housing halves 402a and 402b configured to matingly engage each other and removable attach to the second shaft member 320.
  • the housing 402 is configured to extend from the second handle member 340 to the intersection portion 126.
  • the housing 402 includes a proximal end portion 402a, a distal end portion 402b, an upper surface 402c, and a lower surface 402d.
  • the upper surface 402c includes a switch 404 disposed in general alignment with the bumper 321 of the first elongated shaft member 310.
  • a cable 401 extends from the switch 404 and out through the lower surface 402d of the housing 402 for electrically connecting the forceps 300 with an electrosurgical energy source (not shown) via plug 401a. Cables 403 and 405 extend from the switch 404 and out through the distal end portion 402bb of the housing 402 to first and second electrodes 410 and 420.
  • the first and second electrodes 410 and 420 include lower surfaces 410a and 420a, respectively, that are configured to frictionally engage the inner surfaces 356 and 366 of the first and second jaw members 350 and 360. It should be understood that the first and second electrodes 410 and 420 may be releasably secured to the first and second jaw members 350 and 360 by any suitable mechanical (e.g., tongue and groove) and/or chemical (e.g., adhesive) arrangement within the purview of those skilled in the art.
  • An insulating layer 430 such as a coating, a liner, or the like may be positioned between the lower surfaces 410a and 420a of the first and second electrodes 410 and 420 and the inner surfaces 356 and 366 of the first and second jaw members 350 and 360, respectively, to electrically isolate the first and second electrodes 410 and 420 from the forceps 300.
  • Upper surfaces 412 and 422 of the first and second electrodes 410 and 420 define tissue contacting surfaces that are substantially similar to tissue contacting surfaces 152 and 154 of forceps 100 and 100' .
  • the forceps 300 are assembled and disassembled with the connector assembly 400 by attaching/detaching the housing 402 of the connector assembly 400 to/from the second elongated shaft member 320.
  • the electrodes 410 and 420 are secured to/released from the inner surfaces 356 and 366 of the first and second jaw members 350 and 360.
  • the electrosurgical energy source (not shown) is automatically activated when the bumper 321 depresses the switch 404 to seal tissue grasped between the first and second tissue contacting surfaces 412 and 422.
  • the switch 404 is released and jaw members 350, 360 are laterally moved such that the cutting edges disposed on the tissue contacting surfaces 412 and 422 cooperate to cut tissue disposed therebetween.
  • the embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery. ”
  • Such systems employ various robotic elements to assist the operator and allow remote operation (or partial remote operation) of surgical instrumentation.
  • Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the operator during the course of an operation or treatment.
  • Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.
  • the robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location.
  • one team of surgeons or nurses may prep a subject (e.g., a patient) for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system.
  • a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
  • the robotic arms of the surgical system are typically coupled to a pair of master handles by a controller.
  • the handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc. ) which may complement the use of one or more of the embodiments described herein.
  • the movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon.
  • the scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument (s) .
  • the master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions.
  • the master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon’s ability to mimic actual operating conditions.
  • a medical work station is shown generally as work station 1000 and generally may include a plurality of robot arms 1002 and 1003; a control device 1004; and an operating console 1005 coupled with control device 1004.
  • Operating console 1005 may include a display device 1006, which may be set up in particular to display three-dimensional images; and manual input devices 1007 and 1008, by means of which an operator (not shown) , for example a surgeon, may be able to telemanipulate robot arms 1002 and 1003 in a first operating mode.
  • Each of the robot arms 1002 and 1003 may include a plurality of members, which are connected through joints, and an attaching device 1009 and 1011, to which may be attached, for example, a surgical tool “ST” supporting an end effector 1100, in accordance with any one of several embodiments disclosed herein, as will be described in greater detail below.
  • Robot arms 1002 and 1003 may be driven by electric drives (not shown) that are connected to control device 1004.
  • Control device 1004 e.g., a computer
  • Control device 1004 may be set up to activate the drives, in particular by means of a computer program, in such a way that robot arms 1002 and 1003, their attaching devices 1009 and 1011 and thus the surgical tool (including end effector 1100) execute a desired movement according to a movement defined by means of manual input devices 1007 and 1008.
  • Control device 1004 may also be set up in such a way that it regulates the movement of robot arms 1002 and 1003, and/or of the drives.
  • Medical work station 1000 may be configured for use on a patient 1013 lying on a patient table 1012 to be treated in a minimally invasive manner by means of end effector 1100. Medical work station 1000 may also include more than two robot arms 1002 and 1003, the additional robot arms likewise being connected to control device 1004 and being telemanipulatable by means of operating console 1005. A medical instrument or surgical tool (including an end effector 1100) may also be attached to the additional robot arm. Medical work station 1000 may include a database 1014, in particular coupled to control device 1004, in which are stored, for example, pre-operative data from patient/living being 1013 and/or anatomical atlases.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Robotics (AREA)
  • Physics & Mathematics (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un instrument chirurgical électrique (1) qui comprend des premier et second éléments formant arbre (110, 120) allongés et réutilisables ainsi qu'un ensemble raccord jetable. Le premier élément formant arbre (110) allongé comprend un premier élément formant poignée (130) et un premier élément formant mâchoire (150), et le second élément formant arbre (120) allongé comprend un second élément formant poignée (140) et un second élément formant mâchoire (160). Le premier et le second élément formant mâchoire (150, 160) comprennent chacun des surfaces en contact avec le tissu (152, 162) présentant une surface d'obturation (152a, 152b, 162a, 162b) et un bord de coupe (152d, 162d). Le premier élément formant poignée et/ou le second élément formant poignée (130, 140) sont mobiles l'un par rapport à l'autre autour d'axes sensiblement orthogonaux afin de déplacer les éléments formant mâchoire (150, 160) entre une position ouverte, une position d'obturation et une position de coupe. L'ensemble raccord (200) comprend un logement (202) coopérant de manière sélective avec le ou les éléments formant arbre (110, 120). L'ensemble raccord (200) est conçu pour communiquer l'énergie chirurgicale électrique entre les première et seconde surfaces en contact avec le tissu (152, 162) lorsque les premier et second éléments formant mâchoire (150, 160) sont disposés en position d'obturation.
PCT/CN2015/077340 2015-04-24 2015-04-24 Raccord jetable à utiliser avec un dispositif séparateur d'obturation de vaisseaux réutilisable WO2016169039A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
PCT/CN2015/077340 WO2016169039A1 (fr) 2015-04-24 2015-04-24 Raccord jetable à utiliser avec un dispositif séparateur d'obturation de vaisseaux réutilisable
CN201610256036.5A CN106063723B (zh) 2015-04-24 2016-04-22 用于与可重复使用的脉管封闭分隔装置使用的一次性连接件
CN201620345785.0U CN205885519U (zh) 2015-04-24 2016-04-22 电外科器械

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CN2015/077340 WO2016169039A1 (fr) 2015-04-24 2015-04-24 Raccord jetable à utiliser avec un dispositif séparateur d'obturation de vaisseaux réutilisable

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WO2016169039A1 true WO2016169039A1 (fr) 2016-10-27

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EP3595560A4 (fr) * 2017-03-13 2020-11-18 Covidien LP Instrument chirurgical fondé sur énergie pour saisir, traiter et/ou couper un tissu
GB2588231A (en) * 2019-10-18 2021-04-21 Gyrus Medical Ltd Electrosurgical instrument

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WO2016169039A1 (fr) * 2015-04-24 2016-10-27 Covidien Lp Raccord jetable à utiliser avec un dispositif séparateur d'obturation de vaisseaux réutilisable
US11540872B2 (en) 2017-03-13 2023-01-03 Covidien Lp Electrosurgical instrument with trigger driven cutting function
EP3744278B1 (fr) * 2019-05-27 2024-08-14 Erbe Elektromedizin GmbH Instrument électrochirurgical et son procédé de fabrication
GB2605979A (en) * 2021-04-19 2022-10-26 Gyrus Medical Ltd Electrosurgical instrument
CN114886550B (zh) * 2022-04-15 2023-03-21 以诺康医疗科技(苏州)有限公司 具有可通断滑触环结构的枪式电刀

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WO2009105158A2 (fr) * 2008-02-15 2009-08-27 Interventional & Surgical Innovations, Llc. Instrument chirurgical destiné à saisir et à couper des tissus
CN104434298B (zh) * 2013-08-07 2017-11-03 柯惠有限合伙公司 具有组织限位件的双极外科器械
WO2016169039A1 (fr) * 2015-04-24 2016-10-27 Covidien Lp Raccord jetable à utiliser avec un dispositif séparateur d'obturation de vaisseaux réutilisable

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US20060074417A1 (en) * 2003-11-19 2006-04-06 Cunningham James S Spring loaded reciprocating tissue cutting mechanism in a forceps-style electrosurgical instrument
CN102525639A (zh) * 2010-10-04 2012-07-04 Tyco医疗健康集团 血管密封器械
CN103841911A (zh) * 2011-08-09 2014-06-04 柯惠有限合伙公司 手术钳
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EP3595560A4 (fr) * 2017-03-13 2020-11-18 Covidien LP Instrument chirurgical fondé sur énergie pour saisir, traiter et/ou couper un tissu
US11234755B2 (en) 2017-03-13 2022-02-01 Covidien Lp Energy-based surgical instrument for grasping, treating, and/or cutting tissue
US11766289B2 (en) 2017-03-13 2023-09-26 Covidien Lp Energy-based surgical instrument for grasping, treating, and/or cutting tissue
GB2588231A (en) * 2019-10-18 2021-04-21 Gyrus Medical Ltd Electrosurgical instrument
GB2588231B (en) * 2019-10-18 2023-08-09 Gyrus Medical Ltd Electrosurgical instrument

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CN106063723B (zh) 2021-03-16
CN205885519U (zh) 2017-01-18
CN106063723A (zh) 2016-11-02

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