CA2473512A1 - Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis - Google Patents
Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis Download PDFInfo
- Publication number
- CA2473512A1 CA2473512A1 CA002473512A CA2473512A CA2473512A1 CA 2473512 A1 CA2473512 A1 CA 2473512A1 CA 002473512 A CA002473512 A CA 002473512A CA 2473512 A CA2473512 A CA 2473512A CA 2473512 A1 CA2473512 A1 CA 2473512A1
- Authority
- CA
- Canada
- Prior art keywords
- gear
- surgical instrument
- articulation
- end effector
- drive tube
- Prior art date
- Legal status (The legal status 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 status listed.)
- Granted
Links
- 230000007246 mechanism Effects 0.000 title claims abstract description 31
- 239000012636 effector Substances 0.000 claims abstract description 48
- 230000033001 locomotion Effects 0.000 claims abstract description 48
- 238000012546 transfer Methods 0.000 claims abstract description 5
- 238000010304 firing Methods 0.000 claims description 50
- 230000008878 coupling Effects 0.000 claims 4
- 238000010168 coupling process Methods 0.000 claims 4
- 238000005859 coupling reaction Methods 0.000 claims 4
- 241001366041 Astronesthes gemmifer Species 0.000 abstract 1
- 230000000694 effects Effects 0.000 description 10
- 230000008901 benefit Effects 0.000 description 3
- 230000009977 dual effect Effects 0.000 description 3
- 239000002184 metal Substances 0.000 description 3
- 238000013519 translation Methods 0.000 description 3
- 230000014616 translation Effects 0.000 description 3
- 244000291564 Allium cepa Species 0.000 description 2
- 235000002732 Allium cepa var. cepa Nutrition 0.000 description 2
- RTZKZFJDLAIYFH-UHFFFAOYSA-N Diethyl ether Chemical compound CCOCC RTZKZFJDLAIYFH-UHFFFAOYSA-N 0.000 description 2
- 238000013459 approach Methods 0.000 description 2
- 230000005540 biological transmission Effects 0.000 description 2
- 238000003780 insertion Methods 0.000 description 2
- 230000037431 insertion Effects 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 230000004044 response Effects 0.000 description 2
- 241000208140 Acer Species 0.000 description 1
- 102000007469 Actins Human genes 0.000 description 1
- 108010085238 Actins Proteins 0.000 description 1
- NLXLAEXVIDQMFP-UHFFFAOYSA-N Ammonia chloride Chemical compound [NH4+].[Cl-] NLXLAEXVIDQMFP-UHFFFAOYSA-N 0.000 description 1
- 244000075850 Avena orientalis Species 0.000 description 1
- 235000007319 Avena orientalis Nutrition 0.000 description 1
- 241000963790 Beilschmiedia tawa Species 0.000 description 1
- 241000832799 Bursaphelenchus obeche Species 0.000 description 1
- 101100210350 Candida albicans (strain SC5314 / ATCC MYA-2876) WOR1 gene Proteins 0.000 description 1
- 241001501930 Gavia Species 0.000 description 1
- 241000594011 Leuciscus leuciscus Species 0.000 description 1
- 101100518501 Mus musculus Spp1 gene Proteins 0.000 description 1
- 241000364051 Pima Species 0.000 description 1
- 244000269722 Thea sinensis Species 0.000 description 1
- 241000193803 Therea Species 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 150000001768 cations Chemical class 0.000 description 1
- NEHMKBQYUWJMIP-UHFFFAOYSA-N chloromethane Chemical compound ClC NEHMKBQYUWJMIP-UHFFFAOYSA-N 0.000 description 1
- HDRXZJPWHTXQRI-BHDTVMLSSA-N diltiazem hydrochloride Chemical compound [Cl-].C1=CC(OC)=CC=C1[C@H]1[C@@H](OC(C)=O)C(=O)N(CC[NH+](C)C)C2=CC=CC=C2S1 HDRXZJPWHTXQRI-BHDTVMLSSA-N 0.000 description 1
- 239000011521 glass Substances 0.000 description 1
- 150000002500 ions Chemical class 0.000 description 1
- 239000010978 jasper Substances 0.000 description 1
- 230000036244 malformation Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
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- 239000004417 polycarbonate Substances 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 238000002604 ultrasonography Methods 0.000 description 1
- XOOUIPVCVHRTMJ-UHFFFAOYSA-L zinc stearate Chemical compound [Zn+2].CCCCCCCCCCCCCCCCCC([O-])=O.CCCCCCCCCCCCCCCCCC([O-])=O XOOUIPVCVHRTMJ-UHFFFAOYSA-L 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
- A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
Abstract
A surgical instrument particularly suited to endoscopic articulates an end effector by including an end effector having a geared articulation mechanism that converts rotational motion from a handle portion. A hollow articulation drive tube transfers the rotation motion in some version to a spear gear, level gear or snaggle tooth gear articulation mechanism.
Alternatively, one or more threaded drive rod offset from a longitudinal axis engages a worm gear or flex-neck articulation mechanism.
Alternatively, one or more threaded drive rod offset from a longitudinal axis engages a worm gear or flex-neck articulation mechanism.
Description
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therapeutic :effect (e.g:, endocutter, jasper, cutter, s~taplerss clip applier, access c ' ~ device, druglgene therapy delivery device, and energy device wing ultrasound, RFC
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Positioning the end effector is constrained by the trodar.::, generally these erid~scopic ~ surgical instruments include ~a long.
shaft between tlxe end effector and a ~
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l~,ndle po"rtion.manipulated by the clinician.
This lon~,shsf~
en~blesvinseriiowto a ' . 7 , . _desi~red depth and rotation about the longitudinal axis~of the shaft, thereby positioning ahe.
end effector.
to a degree.
With judicious placement bf the trocar and use ofv r . . ~$rassPers, for instance, thraugYi another, tmcar, often 'this aznot5.nt of positioning is :
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Siu,gical stapling and severing instruments,-such ~as described in U.S.
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5,465:,895, arc an example of an endoscopic suigical irtstiv~ent thrit successfvIl' .positions _. , . . an ' end effector by insertion and rotation.
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More.receatly, U.S.
Pat:
Serial No.
, v'SIJRGiCAI:
STAPLINCw.
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L~TSTRUMENT
INCORPORATING
AN
E-BEAM
FIRING
MMECSM"
to ' 8h~~ton et al.,., filed on May 2003, describes an iruprovedv."E~eam"'.fining bar for.
' ' .
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severing tissue and actuating staples.
Some of the.additional adyaritages include .
' . ' ~ :
affi~natively, spacing the j aws of the end effector, even if elight~y too much or two .
. a: , , littlje tissue is clamped for optimal.
staple formation.
Ivtoreover, the E-beam firing bar ~
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includes en~a.gesahe end elector and staplt cartridge uz a way that enables several .' .
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; Depending upon .the nature of the operation, it may. be desirable ~ tb further gdj~st.the.positioning ofthe cad effector of an eadoscopicsurgical instrument. In ' ' particulaz, it is open desirable to brient the end affector ~at a~, axis transverse to the ~
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. :_' ~' longctudiizal axis of the shaft of the instrument.
The transversemovement of thd'end_.
eff~ctor.
. :~' relative.
to the instrument shaft is conventionally refeaed to as "articulation"..
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This articulated ositio ' ermits the clinic' ' .
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tan.to more easily engage tissue iuaome ~
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instances such as behind an organ.
In addition, articulated positioning y ad~aatageously ~' . allows i; an ; endoscope to ~be positioned behind the end effector without , .
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instrument shaft.
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Approaches to articulating a surgical stapling.
end sev~erirrg instrument tend .
be~icompueated liy integrating control of the articulafiorc along:vvith the contmi of ...'.:..~y ;
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;closing the end~effector to clamp tissue and fire the end effector,(i.c., stapling arid 'sev ring) within the small diameter constraints of an endoscopic instruzrrerit. 1. ~ y ;Generally; the #hree. control motions are all trarisferr~l..through the-shaft as. . ~ , , lori~itudinal translations. For instance; U.S. Pat. No. 5,6 i',3,84a :discloses an . .
' :a,ccordion:Iike articulation mechanism ("flex-neck") that .is articulated by selectively , dravi~ing back .one of two connecting rods through'the.imp~lemerit:~shaft, each rod offset .
' :respectively on opposite sides of the shaft centerline. The: connecting rods ratchet ~ .
' ah~ough a 'series of discrete positions. ' . . .
. ~ ,: .. . . : ; . ; : .. .
.; tooogj -~~ Another example of longitpdinal control of an articulation.
mechanism is U.S.. ~. . ' . . , , ' , : : . ~ , ~jPat.'No.. 5;865;361 that includes an_articulation lick offset :from 'a camtnirlg pivot:~sucls, th.atipushi~g.or.pulling longitudinal translation afthe yticalatioii link,e~'ects ~ ~ ~ ~ ~ . .
.:articulation to~la respective side. Similarly, U:S. Pat. No. 5,797;537' iscloses a similar ~ ~ ~ ~, , :: , ;, , '.~ , : ; ~,:. ~ .., . ~., ~, .;; , , : ~~~~, ~ough . . to effect articulation. . . : , . . , , , ' ' rod the shaft ; ~ . ' . .
laoo,9Z . ; ~ ~ While.~these longitudinally controlled articulation ~echa~usrns have provided- ~ _ .
. ;., . ; :: . : .: : ,. , ,, , , .: certain advantages to surgical instruments such as for:endc~scopic ~stapluig and ~ , ' .
~sev'eriag, it is believed that an.alternative articulation moti~~ri.would provide~additional''~ ~ ~ .~
.:, .: v': .':.~ ~s: v,, . ;, . ~ . .~ y.des~git ~le~cibility. v v . ~.
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i LL.S, patent No. 5,405,344 teaches an endoscogicvsurgical instrument.that, in ~. ~ ~ .
the embodiment (shown.in FIGS. 7-I3); uses rotary motion abot:.t the longitudinal axis .
' to articulate the end effector of the instrument in a conical motion. A~,s taught, the .. ~ .
. r . ~~..articulatitig.end effector uses a ball (convex member .1'74) :~ttaotied to.the end,effectoi ~ ~ ~-: arid a sockeE in a distal end of the hollow support tube'16~: .A
Hollow shaft 188 is' .;,,~ , ~ ': : bent into s"Z°° shape. and has a diatal portion 198 that is bs.~.t to farm: at an angle to :.~ r .' ' v.
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.: .. ~1~.. 'v the ~loagitudi~al axis. Distal portion 198 is ratatably mounted:within a passageway . .1 ' .' v ..
' . ~' ~ ' 1r7~ extending into, the ball or convex member 174, of the etid effector., ~Nhea tk~e' ~; ~ . . ., . ~ , ~ ., ~: y,stal portiow 198 is bent to the same angle as the passageway ~'~8, the end effector. ' ~ ' ..
' ,' ~ ho~dw'shaft 188 can be assembled (ib one position) aligning the:loagitudinal axis ., ' , .. . '~ : r . ofthe,end effcctor with the hollow shaft 188. Rotation of,the ldollow shaft 188 from y ~, ~ ~ ~ ' thi$ .alignment position articulates the end effector in a. conical motion. As sho~i~in. , , :~ .: :.:: . F~~rS 10.13, ;the end effector both translates and rotates.
relative to the. longitudinal , ~ ° , ~ ~ . ~ ' , 1. ; . ~ . ....
. . : _ .l : ~ : ;,' . ails., : Vl?hil~ providing articulation,, the conical motion is not, intuitive and re_ quiies , ' .
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pro~tirnal end of the 'surgical instrument ofFIG.
incYudiag a rc~tatiag articulation ~
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v depicts a perspective, exploded view ,of the haadle portion of the ', ' ' pro~iinal . ~ end ~ of the,surgicai instnunent of FIG.
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, , , portion of the surgiceil iinstr~ineat of FIG.
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.f a,'!~.$tsl portion Df the handle : ~ , ' vcut~a'~vay to expose a rotating articulation.control mechanism.
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- ;rotat~g articulation contml mechanism and have,a rotating articulation -~' . .:i , y , ', , : y .
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depicts a top perspective detail viei~r of a spur, ge'.sr.articulation.
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including a spur gear articulation ~riechanism.
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l2 depicts, a front perspective view of a snsggl,, t , .
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. i FIG. ,13 depicts a top plan view of the anaggl~-tooth axticulation ~. . i?~azy~ asechaaism. cf . , , ' ,; ; . ; .:" , 1 ::
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depicts a side perspective cutaway,view of a..bevel-gear articulatton -. i ~
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~: ~ . ' , ~ ~ortion of the : ~too3?~1' . ' t FIG.. l6 depiots a perspective, exploded view of as implement ~ : p ' v ~
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sleeve, and firing portions.
lao3~l ' FIG. l8.depicts a top view of a dual and flex-neck articulation mechanism for he surgical instrument of FIG. 1.
,' r (oo3s1 FIG. ,19 depicts a front perspc;ctive view of.the.duaL rod flex-neck articulation, .
.; . ~.' . , :mechanism of FIC'r. 18. .
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.' Iaet~'ited I7escrit~.tfoa of the Invention ' tooa~l Turning to the Drawings, wherein Like numerals demote like components ' ;throughout the several views, FIGS. I-j depict a surgical instrument, which in the :illustrative eri.~bodiment is more particularly a surgical stapling and severing .
' 'irlstt<ument~ 10; that is capable of practicing the unique 'benefits o~f the present ~ ~ ,. , invention. In particular, the surgical stapling and severing instrument,10 is sized.for. ~. .
insertion, in a nonarticulated state as depicted in FIG, ;L, through a trocar cannula , , : , ~y~sageway to a surgical site in a patient for performing a surgical procedure. ~nce .. . . ..
,an,ai~iculation z~nechariism 11 and a distally attached eyd effectar.l2 are inserted '~~~ ~e caunula passageway, the articulation zztech.anistn l l..may,be remotely. .
varticulated; as.degicted in FIG. 2, by an articulation control 13. Thereby, the end,' . ~ ' effl;Gtor. I2 .rnay reach behind an organ or approach tissue from a desired angle o~. foi .
' othez reasons. For instance, a firing mechanism, advantageously depicted.
a's an E-beam firing bar 14 .(depicted in FIG. 3), that severs ,clamped tissue, engages an ' ' ~.elorigate channel 1.6 and a pivotally attached anvil 18.
'.'. , . . ; i ... "
'~' too3~1 ~ Tl~e surgical~ and stapling and severing instrum~,mt 10 incxudes a handle portion, .
i ~ 20. c!onaected ~to an implement portion 2Z, the latterfurther comprising a sliaft'23 .i~ ~ . ~ . ' . ' ' i , . , . . . . . . ; " , . : ~ ' ~ . , -dist,~lly terminating in the articulating mechanism 11 and the anti effector 12. The . , . , .
)~an~t~ partiOn 20 includes a pistol. grip 24. toward whi~;h a cr~sure trigger 26 is . .
~ .
pivritally drawn by the cliziician to cause clamping; or ~losiag, of the anvil 18 toward:
~~ ': the .olong~te channel 16 of.the end effector 12.. A firm trigger:28 is farther.~utboard ' T . .. ' : ~ i ~ . ~ . . . ., ' of tl~.e closure trigger 26 and is pivotally drawn by the clinician to cause.the stapling' , .,. ;~' ., y . .,:.. . : ', ,. ! -. .
y ~ ~ : , k : . ~ . . . : ' ' : , ,: ~' . i , '. .: '..:. 'i. ~ ? . '.
- .- , :.
. ~l. ~ .. j . . " : , ,. 1 . _ ' , a . ' , - y : . 'I
. .. ~ . .
:,,.: ; i ' ' ,:
y, ~ ~ _ and severing of:clamped tissue in the ~d effector 12. Therea~er, a release bufitpn 30 . , , is dep'iessed, to:release the .clamped tissue. . .
, ioo3~1 ~ An outmost alasure sleeve 32 of the shaf1~23 Iorigitudinally trauslatee in i ... . . I . .~ r ~ . . . ~ ~ . , . , ..
r ' , ~ respprise to the .cis~stue trigger 2b to pivotally close the anvi'1 18. Specifically, 8 distal ~. j . ~ ~ . '~ .
potion, or closure ring 33, ofihe closure sleeve 32 with respect to the articulation , , v ~ rnech~nism ~1 I is indirectly supported'by a frame 34 of. the. i~apl~ent portion 22 w.i ~(~~ally visible~at the articulation mechasrism 11): ,.At the articulation ~echanisrin 1;~1, , , .aproxialal portion; or,closure tube 35, of the closure sleeve 32 cotninunicates witl= the ~ .
~s~~' onion (closure~ring) 33. The frame 34 is flexibly attachedto the elongate ~, . : ~~ . . _ . .~,; , chl 16 via the articulation mechanism I 1, enabling; articutatia~a in a single plane.
T'he fame ~4 also longitudinally slidingly supports a fiixang dr~.vc tnembex 36-that '.
~cor~unicates .a firing motion from the firing, trigger 28~ to the f ring bar 1.4. ,Only the , . ' ,. , ; . . : ..,:.
_ . . ~~ 14~of:the firing drive rrte3nber~36 is depicted FIG. 3, but:the.f~ring drive y raerizber 36 is described below iurthei detail with regard~to varriou~s versions of a iota~onallycontrolled articulation mechanism 11. . , j . . . ~ ~ '.
. .!: : ~ : 'EC~;,3~1 ~,~ . . ~ : ~ .It will be appreciated that the terms "proximal" and "distal" are used herein a ,, ; ; .. , ~ .. .
with deference to a clinician gripping a handle of an irnstiu~me~nt. Thus, the end , . , ~ - . , r effec~nr 12 is distal with respect to the more proximal Handle portion 2Q.
It will lee .
nY. '.. , ~, ~ . i ether appreciated that for convenience and clarity,~spatial~ termssuch as "verrtical"
.:j . . .. k . ;,. : ..~ , , ,, . ' ~d "~orizontaf.' are used herein with respect to the cirawings~ .However, surgical .
. .h . _ - , . , ' .
ents: are;usod in many orientations and~positions,' and these terms are not ~
~ .
.,.. I . t :.. ... ; , , . ~ , ~ ~
>;~ .'.._,,. : :;:.y;: .'.;. . , : i~.ter~~led.to?be limiting and absolute. , , . : , ' ,1 I , : ..::.:
I. i I
y , , . ,, . .. . . , . .. , , ,. toa~m~: . ~ ~ E-BEAM~ FIRING BAIL . .
,. , _ ' , : .. .. ~ , r : . ~ , ~:~ . :~ . : y : . ....:' ,_ :: .;;;::,:::':
E~a411 ! ; FIGS.. 3:-~. depict the end effeetor 12 employung the.E :bears firing-bar 14 to :,perform a number of fmactions. In FIG: 3, the firu2g bar 14 is proximally po,sitian~i,: . . .
alto .' ..an . eat staple cartridge 37 to be installed~into,the elongatd channe1~.16. . .
g . , . , , .. ~e~~ ~ wr ~ in 38 of the filing bar ~I4 xesides yrittuzl a recess, depicted as: : '' ~ ~ .
In p ~ . . upp P , . , . .
~vil ockef 40 alto~ivin the anvil 18 to be repeatedly opened:=and. closed, v Withvhe ~ ., .
are. ate P .
:~ff~ta~ closed-as depicted in FIG. 4, the fuing jai 1,4 is advanced°in engagement, .' . .
. ~ . . : .- . .
~, .with the anvil 18 b having the upper pin 38. enter a longitudinal=anvil ~slot 42: ~ A
,. ~'. v . , . ~ y . . . , _. . .. . .. ~ ~ .v ..
v lows xr~ost pin, ~or firing bar cap 44, engaged a lower suiface of the elongate :channel ~ , _ .
-~;-~W.:...:'~;-:~':. , .: ' . <; ~; ~ ~ . . ~ ~ w . : . ~ ~v ~. .- . ~~ ~,..
.:~;..',:~y;
i..,:.:;.~~.,.:. _~,r:r,;.~~.v ; ~.: .. .. i , . , . , . . _. , , ;. . ~ ~ -,.
:,. , ...,., ,,.
I : ~
.- _ ~
; ,::.,. - ~.~ ' ' ' ~ . . 8 ~ . , . ~ ~~ ;. ":: ...,.
.._, ::.: ~ . ... : . ..~:.. ., : . ..: _ ~ ~ . ... ~.. i; .. . . :. .. . ~..
:; , ::.,,v, ~j: ..v., ,_.
. ~ .:- ' lb by having.the firing bar 14 extend through a chann~;l slot ~5. ;A middle pin 46 . $lidingly, engages a top surface of the elongate channel.'16,, cooperating.
with the firing ~ ;
~i ~~. c~ ~. Thereby, the firing bar 14 affirmatively. spaces .the end effector 12' dining firing, .overcoming pinching that may occur with a nzirumal amount of clamped tissue . ' ~aiid overcoming staple malformation with an excessive; amount of clamped tissue:
~' ao~i burin firm a distail resented cuttin ed a 48 between the a er in 38 ( ! g ~ Y P g g PP P .
! and riziddle pin:46 of the firing bar' enters a proximally presented.vertical slot 49 of the' , staple cartridge 37,. severing tissue clamped between the staple 'cartridge 37 and the anvil! 18. A;s .~shovvn in FIG. 4, the middle. pin ..46 actuates.tJze Maple c~Gridge.3'7.by t .: ~ . , entering into a firing slot within the staple cartridge 37, driving a._wedge sled 4I. into . ;
;.
upward carisming contact with staple drivers 43 that in turn dnvea plurality of staples ~~,out of staple apertures 51 in the staple cartridge 37 i~ato forming coatact with staple ' dockets 53 'on ari inner surface of the anvil 18. FIG. 5 depicts the firing.bar 14 fully ' r' distally traz3slated afrer completit2g severing and stapling tissue. v .' lo~4sl t TWa-AXIS HAIi~LE
(opal, , i With reference to FIGS. 6-7, the handle portion 20 is comprised of first.and y second base sections. 50 and 52, which are molded froxd a polymeric material such as, a glass-filled. polycarbonate. The first base .section 5,0 .is proyided.witlz a plurality of y cyluidrical=shaped pins S4. The second base section 52 includes a plurality of . y , ' , .~xter~ding. tirien~bers 56, ,each having a hexagonal-shap~;d opening, 58.
The cylindrical-. . , shaped pins 54 are received within the hexagonal-shaped openiygs S S and are a. . . , .. ... i . . .:
frictionally~held therein for maintaining the first arid second base';sectioas 50 and 52 , , ' : ~ tn assembly. , . ~ .':
' , ..
Eoa4~j', .. ; .~ A housing cap b0 has a bore 62 extending comf Ietely through if far engaging ~d rptating~ the implement portion 22 about its longitv;dinal axis.-, The housing cap 60 . , includes an, inwardly protruding boss 64 extending along.,at least a portion of the bore , .
~Z, 'fhe protruding boss 64 is received v~iithin a longitudinal slot,66 formed at a , . ~1 proxirnalportion of~the closure sleeve 32 such that'rotation o~~the.housing'cap 60 _'.b,:.~ ~ . . .~ .. . . . , . . . . ..
appreciated that the.boss 64 further effects Totation'af the ctosurc sleeve 32. It will be .. ~ ~ .~~ . : . . ~. .
extends through frame 34 and, into contact with a portion of the fi~ing~drive, member , ;, w,;. ; . ~ . :, ... ; ~ '~ . v : : ,, .
. : . .. :.
~- f~., ;~~'1~' ".~~ .,, ..;;~. .'. " , ~ .. , , :', ; .' '~,, , , . - , ... .
. ~ .. .. ' . . ..' .
g , ,..~, ~. > .. . ,.
y '~ ' .. .
.:._ ~ .. : ~ .; ..
r . ..~ ~~ _ ....._ _ _ _ _..._ . _._ a __ ___~ _ ._ _.___.~____._____~.. ~~
.~_~.~~
CA 02473512 2004-07-09 ..E
,. , r . .
. .. ; ~ . .__ . . : i L ' ~ . ~~ C i - , it . . . . . v .
- , . , . - . . ., ' ..
. , ~,6 to ;effect their rotation as well, Thus, the end effecto;r 12 (not shown. in FIGS. 3.4) rotates with. the housing cap, 60. , . .
'~(oo~ A proximal end 68 of fhe fra.-ne 34 passes proxinxally. through the housing cap .' . , , ,6.0 .and is provided with a carGUmferential notch 70 that is engaged by opposing - ' -~ _ ~ : . ~ .c;~anriel s~ctuemei~t. members 72 extending. respectively from the ,base sections. 50 and 5~'2: Only the.charmel securement member 72 of the second base section 52 is shov~m.
r The channel securement members 72 extending from the base sections 50, 52 sense to secure the frame 34 to the handle portion.20 such that the frame ~4 does not move . a, . . . , longitudinally relative to the handle portion 20. .
. :. toa4~la ~ .. i Therclosure trigger 26 has a handle section 74, a. gear segment section 76, and;
. , , ~ . , "' :.
an intermediateysection 7,8. A bore 80 extends ttlrtough;othe intermediate section78. ,A, .
.:;-~. : . .... . . ,, - . - .
e~rlincirical support member 82 extending from the second base section ~2 basses . . . , '' ~ - t'"brough therbore 80 for pivotally mounting the closure tri$ger.26 øn the handle ;.
i t . _ ~orti~n 20. A. secaac~ cylindrical support member 83 extending from the 'second base , $~~4n 52 passes; through a bore 81 of firing trigger 28~ for pivotally rriounting on the.. , l~aiidle portion 20. A hexagonal opening 84 is,provided in the cylindrical support , , . , . ' : m~b~ 83for-receiving a securement pin (not shown) extending- from, the first base .; i ',; '. , ; , - ~.;;.,: ~ .' ' ~ ., section 50, v , , ' : . .' .
Eo;,~sl. ~ A closure yoke 86 is-housed within the handle portion~20 for reciprocating- ~ ~ - .
. . .,, ~. : ~ . . ..
movensent therein and SeNeS to transfer motion from the closure trigger 26 to the' , ' ~, : . ~ i . . ' ~ . : ~ . ' ' ' closure sleeve 32. Support members 88 extgnding froth the second base section ~2 y . .
.. . . ..
' . and, sccure~nent member 72, which-extends through a recess 89 in the yoke 86, . ~ - ' supp.ert the yoke 86 within the handle portion 20. ' , -~ .
- ~ ~~ (~~sl , ' ~ A.l~x~ ~ gQ of the closure sleeve 32 is ptnvided with a flange 92 that is, . _ ~. . . .
snap ~fitted'into.a receiving recess~94 formed in a distal ~.nd 96~ofthe yoke 86. A~, ;
: ; :. proximal end 9,8-of the yoke 86 has a gear rack,100 that is ~ngagod by the gear j ' ~segnient seerioa 76 of the closure~trigger 26. When the-closure trig$er:~6 is moved:
~ istol. 24 of the handle onion 20, tha,y~ike 86 aid, hence, the closure-. ~.
tawa~rd.tb.e p . . grip P . ~ . :
.. ~ : sleeve 3Z' n~rove distally, compressing a spring 302 that~biases the.
yoke 86.proxitnally:
.' ~:d' ~:' . ,-'4 :'' ~ . .. I . . ~ . . ~ , . ~ '. ~ ' .
. ~isxal movement of.the clo.sura sleeve 32 effects pivotal translation movement .of the'.' . , w. ;' ~ ; . . v; ' ~ . : ~. . .. ' .. .. . ; .' ., . :'_~
.; ,. .. - . ~ - y . _.. ~ : ,. .
' ~ ~ . ' ~ ~ ~ ' .
'. . : . , ' -. ~ . .
.. , i ~ . L ' .. . . ' .: .
. . '. . . ' ~ . : ~ .' ' ' ' ,. : . . . ' . ~ ' ~ ' . . " ': . .' ' ~.' , ; ' ,, .
' . 4 ~ _ , . , l .y .. .: ._. ' ~
}: .,. :.: :. ~. . . .. .. ~ . .. . .
anvil ~ 8 distally and toward the elongate channel 16 of the end effeetor 12 and, ' ~ ;
proximal .movement effects closing, as discussed' below.
1.. ~ ., ! 1 ~oo~~~ ~ ~ The closure trigger 26 is forward. biased to ari open.positiQn by a fFOnt surface . ': ~ ~' 1 ~~ interacting with an engaging surface 128 of the firing trigger 28. Clamp first .~
'w . . ~ ~ ~ hook 104 theft pivots top to rear in the handle portion 20 'about a pin .106 restrains ~~ aioverrient of the firin tri ~ er 28 toward the pistol grip ..24 uatii the closure trigger 26. ;, , _ . g gg . ~ ~ ~isclsr~,ipzd to its closed position. Hook 104 restrains fzting-trigger 28 motion~by engaging a lockout pin 107 in firing trigger Z8. The hool~.104: is ahso in.contact with ., >y. , .. . ;. ;
,tpie cldsure trigger 26; In particular, a. forward proj ectiora 10S of.the hook 104 ~~ ~ enga~s-a member 110 on the untermedtate section 78 of the closure trigger 26, tha . ~ ~ rriember 110. being outward of the bore 80 toward the handle. section 74.. ~Hoo~ ,104. is.. - , .
. ~ ~ , .: . . . . . . _ biasef towaid'contact with member 1 IOQf the closure trigger 26 aiid engagement, with ~.
,'ldeko I t is 107 in firing trigger 28 by a release spring l i 2. . As. the closurearigger 26.. ~: . : .. .
. . ~ P . , : . . .
,~I ~~ F ~ . . . ' '~ .. ' : ! is depi~ssed; the. hook 104 is moved,top ~to rear, compressing the release spring 112. . .:: .. ,.
;, ~,~ is~captured between a rearward projection 114 on the; hook 104 and a forward ~ , ; ~ ' . ' .. ~ '.. :v:_.
. ,pro~ec,~ow 116 on the release button 30. : . ' , v':,,',~, :;~: ,.;:, ';,~ ; -';.;,. . ,. ~,. , . . , , ,, ~ ~ :
lao~y ~ As the .yoke :86 moves, distally in response to proximal tnavemeat of the : ~ .
cosine trigger 26, 'an upper latch arm 1 l 8 of the release button° ;3Q
moves glong an ..
°u~per'surfaoe 120 on the yoke 86 until dropping into ari upwardly'presenced recess, ' ~. i ' -. ' ., .
,1~2 iti a .proximal, lower pbrtion of the yoke 86. The release spring 1 I2 urges the . . .
. .release button 30 outward, which pivots the upper Iatch~ arm 2,18 ,dov~mwardly into ;y .: ~~; n, .. eti ~a 'ement vvith the a wardly presented recess 12Z, ttteiceby~ Locking the closure ' , ~ ~ . ;
,gg .. P
ey 26 iri~a tissuo clamping position.
.. gg~ ;. . . ,' .. . ..
.
.., ' . " i The:Iatch arm 118,can be moved out of the recess 132'to rel~ase.
the anvil 18 , ' .. ~ , .
yy p~~g :~e release button 30 inward. Sgecificall'y, the ugpei~l'~teh arm 118 pivots. .
upward about,pin 123 of the second base.section .52. The yoke 86 is then peimittedao' . . . ' . .
~wmove~ roximaliy in response to .return movement of the closure trigger 26.
. ,, .! P , : . . . , . ; : '~ ;
~A fiiriag: trigger return spring 124 is located within the handle portion 20 with .
i:: ; tocs3'; ~ . . , y ~ ~' ~' one~,.ehd. attached'to pin 146 ofthe second base section, f2 arid the:-othervend attached ~' ..: I : . . , , '. to a pm 126, on :the firing trigger 28, ~ The firing return spiW g 1~24aPPlies a retuxn . . .. .
.. i . . . . . . . ..: , . . .. . . . . .
' force~ta the; pin 12b. for biasing the firing trigger 28 in a direction-away from the pistol., '.
' .. ' ... ~~. ' . .. i .a , : . ' : -: ~ . : ' . .- I 1- ,. ' : . . _ . , . : ~' .. ~ .. , . r~.. v . w : ~' w.. . _ . ; , : ,.,,, . ' : v: :;,'... ;..
',.,,: . ,' ..., .. ~ :, . .;. . ; ; .: . ~ . ~ .. - . : .,, ,,:,.,:,,~ .. ,;
:. - . .;..
I ~..~-. ~....
'. :. . . : .... : ,: . . ; ~ ~ . ' ~ .. ~.. :; . . ~. . ',.
grid ~4 of the handle portion 20. , The closure trigger 26 is also based' away from . pistol grip 24 by engaging surface 128 of firing trigger ~28 biasing frost.
surfac.8 .130- o#' g yosure tri er 26, $ ' ' toos~l~~ ' As the closure trigger 26 is moved toward the pistol g~=dp ~4, its .front surface .
..'. . . - ~ 1'30 engages with' the engaging surface I28 on the fuin,~ trigger 2$ causing the fuing . ' ;.
'. ' ' triggey 28 tc move ~to its "firing" position. When in its fuing position, the firing. , . .
:: . . . ..
dagger 28 is. lpcated at an angle of approximately 45°'to the pistol grip Z4. After ..
' ~ ' stapled firing, the.'sprirtg I24 causes the firing trigger 28 vto return'ta its initial position. ~ , . : n ~.~ 1 . . ' i. , Du.~ing the xetum movement of the firing trigger 28, its engaging surface 128 pushes .
'f''. _ . ~ :against the front surface 130 of the closure trigger 26 causing'the closure trigger 26 to:.. , : .
... , i ~ its ' ~'tial asition: A sto member 132 extend3 from the ~secorid bas s~
~'ori ~ . ' v v ~ return to . uu P P . a ech ,. ,. . , '. ':c : ~ . ~ 5~ ~toyrevei~t.the closure trigger 26 from rotating.beyond its.initial position.
~,~ ; ..f :,'~ :y . . ,.., . ,.. ~, , ' ., ,.,; , ,, i ., . . . , . . . ~ ; ~.
. y . v .
. : ta~ssj. ~ ' The stugical stapling and severing instrument 10' additionally includes a . ~ ~ . . .
a:..: , ~ ~ . .
r~cigr~cating section 134, a multiplier I36 'arid a drive yeniber I3~8, , The . .
' !: ~ ~ ~ ~ ' r~ciprdcating section.I34 comp~.ses a wedge sled, or viredge,sledin the implement .
Y ~, .' ,. . v, , I . - ; _ . .
.. pp~o$~ as (not shown in FIG. 6-7)~arld a metal drive rodwi40.
5~ ~ ~ , foossl ' ~ ! The drive member 138 includes fast and second gear.Taclts 141 and '142. A
. . . ..:
. '. fixst nptch 144 is provided on the drive member 138 intermediate the first and,second . .
gear,rachs 141, 142. During~,ret~.~rn movement of the firiyg trigger; 28, a tooth 146 on , ttie'friag trigger 28 engages with the fast notch 144 for returning the drive member ~ : .
.1~8 to its. initial:position aRer staple fuing. A second. notch 148 i~~
located at a . . : .
. . ..
proximal enii of the metal drive rod 140 for locking the Enetal driive rod 1A~0 to the , . . , v upper hatch arm 118 of the release button 30 in its unfired position:
i. . : . . ,.
' ; ~~~~1 ~~ The multiplies I36 comprises first and second integral pinion gears I50 and :152. The first integral pinion gear 150 is engaged with.a. firsi gear,.:rack 154 provided oa themetaldrive rod 140. The second integral, pinion gear, IS2 is~ engaged with the .
v fii'st~gear rack 141 on the drive member I38. The first integal;piriion gear 150 hasva r.... . ~ :.. ~ ... , . .
' . : fast d~ametez, atrct the second integral pinion gear 152 has. a second.
diameter hat. is... ~ .' '';~. :.. ~' ".'. ~.. '. . r.sa~alketr~thsnthe'firstdiameter, ~ .: , .:,. y ;.:.. ,,,:" ..,,.
. . ioossl .; . .. ~ ROTATIONAL ARTICULA?ION CONTROL. .
.' . . ' : . ~ ., , , - .'... . .
' ~ ~ _ ' . ; , ' . , . ,, .: :a: :.: : ~' .: , .. , . .. W~.' :;.. : ..~. ~ ~ : ..:. .. ' v. .-:y. . . .
.... :..
j . . . ~ ; , ._..' ~i ~~ , , s , ~ : ' . , ' , , loons? r, With reference to FTGS. 6-9, the handle portion 20:adva~tageously .
incorporates the articulation Control 13 that both rotates; the .irraplement portion 22 about the longitudinal axis df the surgical instrument lf) aad articulates the end effec~or I2'to an angle with the lonoitud~nal axis. A ho:llow.articulation drive tube 200 ' . i : _ .
is coucentzicaily''Iocafed within the closure sleeve 32 and is operably coupled to an actuation leuer 202 such that rotation of actuation lever 2:02 rotates tube 200 about the ' ~ _ ' ;
longixudinal axis and causes perpendicular rotation or a;rticulatxon of the closure ring .
. . . : '.
250 and end effector 12. This articulation of the closure ring ZS.Q, corresponds to the degr ie and direction of rotation of actuator lever a02 vi'~wed. ~.nd :manipulated by.the:
'' c?~inioian. I~ the illustrative version, :the relationship is one to one, with the d.eg~ee of rotation of the actuator lever 202 corresponding to the d.egree..of ~rticuIation from the .longi~uiiinal axis ofthe shaFt 23, thus providing an intuitive indication to'the clinician.
yt gill be appreciated that other angular relationships inay,be~seleeted.
C ~ ... ' ~ .I . ~ _ .. ' ~. . . " . , . ~ ' r v 'fa~6ol ; The~artiEUlation control 13 includes a, pair of mirrored articulation . .
.tradsmissiori'housings 204 that are attached to the housing cap 60~.
lVtozeover, the ; ' ' . .
articu~ation,trangmission housing 204 includes longitudinally ~hgned external Tabs i 206 that a chisieiaa twists to effect rotation of the articul',ation transmission housing.
;, 204; and thus,.of the. end effeetor I2, about the longitudinal axis of the implement v portian.22 The actuator lever 202 is attached to a cylindzical articulation body 208 ;
~~~ aIsides within a' cylindrical recess 210 opening .generally upward and pen~..e~dicular to the shaft 23. The lowernosf portion of the articulation body 208 , irlciudes prongs 212 that snap &t into an opening 214 in the. articulation transmission . . : :, '' housing 20~ naar to the shaft 23, the;pxongs 212 grevent:ing the articulation body 208 ~:
from being withdrawn from the..cylin.drical recess 2I0.
' ~ ' y :,.. _ . ' ' ~o~~tj ~ , ~ Azznularly presented gear teeth 216 are located about t~,e lower:pomon of the , ,..
,~ atliculation body Z08 and mesh.with teeth 218 on ari arr~culation yoke 220 The ' aa,'ticu~ation yoke 220 straddles an articulation recta~ngul,~r wiadow~222.forinedyn tie ' .
~ ~closur~ sleeve 32. Closure sleeve 32.is slidably moveal~le.witl~izii the articulation , ' control 13 (in the longitudinal direction)'. to close and open the ~nci effector 12. 'The ;.; axticu~ation drive tube 200 moveslongitudinally with the closure sleeve'32 relative to: .
I.
the fined articulation coatrol 13. 'UVindow 222 provides ~Iearauce~for a boss 224 ' .
~, . ; . ..
~nvciar~ily presented from the articulation yoke 220 that pusses through the rectangular ' :.. , : . .: _ . i, :. ', '.. , v.
_ ; ,.
.. . -'I3 -. i . i ' . ' . : . . ~..:
'1 , <;
y ' ,, . . .. ~ ; ~ ~' ~ . ' : ' :. , ' . . : .~ ' ' . : ., . :
~wi~idow 222 to engage a slot 226 in the articulation drive tube .20Q, longitudinally . .
;ypositionirig the articulation drive~tube 200 for rotational motion:
.Thehollow ~' ar<icuiation drive tube 200 extends.longitudinally within the ~clasure sleeve 32 from,'.::
..
' ., _ ;
~rthe articulation mechanism 1 x cad terminates distally.befose the locking tabs.2271.of ~. . . . .
. :ahe closure sleeve 32. The tabs 227 are inwardly bent behind the proximal face of the . . .. ' ..
~~articulatio3~ drsve tube 200 and thereby retaining the ariticulatioa drive:tube 200 n the ;shaft 23'. , .. .; . ' , . . _ 1. : , , ; :~. -. ;. . :_, y ,. : , :....,y . ~ to~os~~ ~ It should be appreciated that the articulation tra~nsmissioa housing 204. is , /. E operatively associated to the closure tube 35 of the shaift 23.
Th~:housing cap 60:
:: ~. ~ ~ . . w . ~.
.. ~ ~etaius the~articulatiori yoke 220:in the-arCiculationaraasmissian.~ousirrg.204 and: . . , .~
.~etaitss the :articulation control I3 within the handle portion .20 by presenting , pro~mally~ an outer diameter circular groove 228 that, engages a circular inward lip . , . ..
. .. ; : , . . ~ . .
' ' 230 at the distal opening of the assembled base section:a 50,, 52. ;1 ~ .
. ', . ,..
.' ' , , v . . ..
;,:, . . ' ,~ (~os33 . , ~ FIGS. 10 and 11 depict the gear articulation rnachaaisa~
11. of FAGS: .1-2 in .the .
~o~of a spur.gear articulation mechanism,Z40, which is gesaerally the same nay : .
desc~i'bed.above but.with a,dditioria3 articulation driving; eorhpanents ora:.the other side. , . ~' bf the attioulation mechanism 240 to thereby iacreaee perinrmanGe..
Articulation :. ~ . ., . ;
r~: .; - . . ~ . ~ ' r r ' m~ ' 'sue 240 has a rotatable hollow articulation driun tube .24~ that is ,: . ~onc'~ritric~lly 1'oeated within closure sleeve 32 and has a.
distally:projecting gear :. , :y,:,...,.:~: : . . . . . . . . .'.
section 244 about a, first circumference portion 246. Gear seetion 244 meshes with a ,' ' ear 248 attached to and ro~tirr~alP ro'ecting from elosure:=ing 250 which .. ;
. : . .
. ~ 'spur g . P Y P 7 . , :.1 ~ pivots about pins 253 extending through first and second pivot paints.
25Z, 264 . . ~ ' . .
.~ ~ ' . re actin distall from the closure sleeve 32. Thug, an, articulatipn pivot axis passes w'. . ~ .
P ~ g . Y ~ ,.", through both the first and second pivot.points 252, 260:and pins X53 ratatably couple ~~
w' . .:
. : .. _ v ~ . _ ~ v closuxe ring 250'to 'the closure sleeve 32. Rotation' of drive 342 eau~gages, the gears 242.' ~~ .
d..~$ 'cad articulates closure rin 250 about first. and ~ecoad pivot points 252, 26Q, y'' g ; . . ,,' . ',. ' ; ; ~ ~ . v:
yoo6sr:' ~~ . . ! 'fo. inc~~ase the.effective surface area of gear contact-bttv~een.the hollow _ _. ~ '. :. . .
' .;articulation:drive tube 242~and the closure ring Z50, a s~:coad~Circumferenae;portion : , ~.
. ~, . , .254 df the hollow articulation drive tube 242 has a recessed dnta~ly projecting gear .~ . , :: .. . ; . _, section 256'extending therefrom. Gear section 256 is operably coupled to a,second . , .. . . . .
~, spur gear 258' attached to and proximally projecting frptn an opposite lateral side of ' I . ~. .
. ;.. _ ~ ._. ., r14~ . ' ,, : ',,.
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the closure.ring 250 by a reversing gecr 262 pivotally supported.by the. frame 34.
.. , , > , Reversing gear 262 engages both the recessed distally projeetm~:gear section 256. on one side arid the second spur gear 258 of the closure ring 250 ~n the other.
iaos53, . ~ When ttie closure trigger 26 is actuated, both tile hollow articulation drive ube ,. 242 surd pivotally attached closure tube 250 of the cloeuso sleeve..32. are moved _ , ~~st~~Y to close the'anvil l8. 'The closure tube 35 of thE;. closure sleeve 32 is spaced .
away;frorn the closure ring 33'by pivotpoints.252, 260 pinned to:pivotvoles 2G4 and . : ~:~g centered in: spec gears 248, 258, , and a frame opening 268 that ~exterids 'tneretnrough. .The frame opening 268 provides clearanc;e.so that, the p~oximal'edges.:
of W a closure,ring 3.3 and the. distal edges of the, closure tube;.35 .of the closure sleeve . ' . , ~ .
;_; . ~ ~ 32 do~not collide. during azticulation. . : ~ . , ' , . , ~ , ', ~oo~~ ; FIG: I I depicts in disassembled form an implemverit .portion.2'~d, that includes .. .
' . tbe~spur gear articulation mechanism 240. A frame 272 is.Iorigitu~i~aaily attachable'to ' 0 icted in FIGS. 1 and 2 with a. .bushiri 274 on its . roximal : ~. . . _ . .
..
heha~.dle,portion2 (dep . ) ~.y: p, ; . ~,'.~.: .'.y.., ~.:' end fqr rotatingly engagement thereto. A frame trough':~76,farmed by an opening 278.
longittidir~a.lly aligned with the center of the $ame. 272 is longer t~an~a firing . . .
' ~
connector 280 that slides longitudinally within the. framitrough 2'7.6. The proximal . _ .
'- end o~ the firing, connector 280 rotatingly engages the diistal end of the metal drive bar 1~0 .(depicted in FIG 6). The distal end of tile firing eoiuxectQr 28~
includes a slot X82., ta,~°Lat receives a~ roximal end of the firing bar.l4,.attached therein by pima 284: .A.
,, . , p ,; ' more .distal portion of the firing bar 14 is positioned within a lower', groove 286 in a , . .
fizing'bsr slotted guide 288 that is distally engaged with an attioulating .frame.memb~r ;, 290 , , . ' . . . ' . .
and the,;frame 2.72. .
i , ' v. .
. X006?~ ~. i Articulating fraiae member 290 has a channel=anchoring member 292 that .
distah~ attaches.to an attachment collar 294 of a proxiWal portion in the elongate. . . . . , ., .
cliann~l 15. 'The firing bar I4 passes through a lower slot 295 in the;articulating .
frame !member 2g0. . The articulating frame member 290 is spaced. away from the.,. ~, distal I~nd of the. frame 272 by the firing bar slotted guidle 288 and~~flexibly attached ' . ~ thereto. for aiticulation .by a resilient connector 296'. . A ~r~idened ,pi'oximal end 298 ctf . , . the resilient connector 296 engages a distally. communicating top recess 300 in the .
. : ..i v .. ;; ~. , distal end ~f the'frame 272 and a widened distal end 30~ of the resilient connector 296 . . .
v... 4, e_ . , ', : . . ; : :,.
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t ~,.....
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:~g~ges a proximally,communicating top.recess in, the arxic~latiag frame member ~29(~
Thereby, the elongate channel isyttached to &xe handle portion 20, albeit with . a f~exible portion therebetween.
~
_ (oohs) ;
1"he elongate channel l6.also has as anvil cam ;slot 3Ob that pivotally receives Iart .arwil pivot of the anvil 18.
The closure ring that encarnpasses the r : that engages an .
articulating frame member includes, a distally pres~~ted tab .. , ~nvi~
feature proximate but distal to the anvil pivot on t3ie anvil to thereby 'effec't opening: , When the closure ring Z50 is moved fc~rwa=d, its distally presented ~ g face 31'4 contacts a tamped cylindrical closing face 31 G, ~los':which is distal to tab, ~ , f the ~rivil 18. This.canuning action closes the a~rvil 18 downward o tmtil the . , , closir<g face 314 of the closuie ring 250 contacts a flat .cylindrical faoe.318 of the anvil: : , . . . , .::
,IB. , . . . ~ ~.
.
, . ,"~. s, :y , ,, ~, ~':;':, . AGGLE TOOTI-I ARTICULATION MECfLANIS1~I ; . .:.~ . . .
.:.~.
v.. .._ tva69j SN
' .
(0001 ' FIGS, 12-13 depict an alternative articulation mechanism 350 for the surgical: . , stapling and severihg instrument 10 of FIG. 1. A snagj~le gear conaectiou 352 is . , l forzriring a50 (not ~ed therein by positioning a: single spur gear 354 oi" a clnsure I
depicted in FIGS.
I2-I3) to .the longitudinal axis of the:
closure ~g 250:
The snaggle gear . . connection, is completed by slanted teeth formed at a distal end of a .
:
.
~
.
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.
;
~lus~a'tubb 360.
Pairs of slanted teeth slope towftid each other registered to one side ~f the :spur gear with other pairs of slanted, te~ah slop~g toward the other .
_ ' .
:
.
, , side ofahe:apur gear 354.
This sr~aggle'gear connection achieves a high gear ratio ~, . , -r .~,y~~a elatively large degree of articulation for a givea~a amowat.,of rotation motion ' ; ' ~tiott~
the longitudinal axis by the, closure tube 360.
It should be appreciated that a , various types, of interconnections between a shaft and .an eud eff~ctor may be each dace 4f the spur gear .
.
.
.
positiohed around the articulatiomnechanism or about .
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WOR1~I
GEAR
ARTICULATION
MECHAN1:SM
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'FIG.
depicts a worm gear articulation mechanism 370vfor the.,surgical I
' , k stapling, and.
severing instrument of FIG.
1.
A, clos~ixre iing is depicted p~attially .
.cutawa 'to, ~
ose,two articulation 374, 3?6, each off~~et laterally from the y , 'r r y:
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.lonmi'tudinal.axis of a closure tube 378. The closure ring 37yis.~ivotally carmected at ,. :v.- . ' ~...- i ~ , ..
pivot' points 380, 382 extending from the closure tube 378, the pivot points 380, 38~ ' ' ' defining a pivot axis, A, concave face spur gear 38~i of hourglass.,shapc is aligned .. vvit~.the~pivot axis and attached to the.closure ring 372. Concave face spur gear.384 is pi~toting about an interzral pivot point 3S6 distally projecting fromyhe closure tube;, ' ~ 378. ;Each articulation drive. tube 374, 376 includes; worm gear-teeth 388 , . ~ , eaca~passiag at least their distal portions that enmesh with oppnsite.,sides, of the '' ~ eoncave~face spur gear 384. Thus, by counter-mtating.the two articulation drive tutzes _ ' , ''3?4, X76, about the longitudinal axis, the closure iiag 372, and thus the end effector.. .
32: (nPt shown in FIG. 14) is articulated.abaut the pivot axis. ~
... ~ '.
(oa~3~_ . .~ ~ rt will be appreciated that only one articulating drive~.tube::374, 376 maybe .
Hsed.' In advdition,.in plication wherein a cavi 390 for a aria ~ bar I4 is not .~y required, ~it v~!ill be appreciated that the concave face spur gear. 38;4 may be centered ,, '' ian~ahe pivot~axis rather. than offset as depicted. Moreover, valthough a concave' face of Hourglass shaped spur gear~384 achieves a large context area with the articulation. ' ~ . drivetuhes 374,' 376; straight or other shaped-faees may be:
used:..F'urthermore, the c articuilatiori drive tubes 274, 376. may be solid or hollo'v. .
~~6~aj~ BE~EWGEAR ARTICULATION MECHANISM . , ,; , . .;, . , _ . ~ . :.
~ :~too~sl FIGS.' 15-17 depict a bevel gear articulation.meGhanism 4'00 for~the surgical ' stapling and~severing instrument 10 of FIG, 1 that also produces articulation from rotation of a member about the longitudinal axis. Tnsteact of a~hieviag greater ~ ~ ~, r~-ngth in.the..gear connection by inclusion.ef a reversing gemr; an.aggle tooth gear, or.
V . ~ .. ' '' 'I . . . , . ' .~ .. , a worm gear.type of connection, a bevel gear section 402 is,provided that is coupled ~ . , , - . , ' . . ' . ; ~' ,. '' ~ ~ ~ ~ . . ~ '. .
.. ~, . . ~ : to a;-~ iartieulstion drive tube 404. In FIG. 15, drive tubs 404:.is' shown sectioned xo ~ ~ , shov~ri elements within. Bevel gear section 402 of tuba 404.iaeshes with a bevel spur ~esr 405 ~foirtned from a closure ring-408. ~ . ~ . ~ .
., . ~ ; :' ., . ~ ':
aao~sl With~particular reference'to FZG. 16', an implenaent portion. 410'is d~gicted hiavit~g additional advantages, such as the bevel gear articulation mechanism 400 .
. , ~ -. iaclueling attachable portions, specifically a pivot conrAecticn 4I4':attd the bevel,gear : ~ . , ~ ' , :o; ~ . ' :. . v ~e~,an 40Z;~that are riot formed respectively into a,closure aiibe 4:16 or.the articulation . ' ' ...
Q.~wc~tube 404, whereby simplifying manufacturing processes why facilitating a shat , ~~
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i v , .. : : ~ I7 ~ ' ' :~ : , ' .. ', . . _. .. . . .::' . ' ,, , ; ;
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t .. . , . _ :-f, , n . ', . . . , ... . .., . . .
r ' ':. 418 of selectable lengths. In a3dition, the assembly of the. b..evel gear section' 4Q2 tn ~a separate articulation drive tube 404 allows fox a constriction 42Q inside'the bevel gear section 402 to be confined to only that portion of;the shst~ 4Y S adjacent to bevel gear . .1 ' , sec~ioit 402. ;, . ~ ~: . ~ ,;:
~'~ ' " ' too~~j : ~ Azesilient support section 422 couples a frame 424'distally to the end effector ~
f . ' ~, '. . . ..
. ~ . ' I2 through. this constriction 420. A proximal end 426 of the'frame 424 i.$ - , .
longitudinally positioned to the handle portion 20 (not depicted;in FIGS.
15:17) for- .
irotatingly~en~agement thereto. A frame'trough 428.fornied by ari.opening 430 . .
', ~ . '.longitudirfally .aligned along the longitudinal axis of the frame 42~
is longer than a ' I ' . . . , .
,:firing conaector.432 that.slides Ioagitudinally within the frame trough 428.. A
: '!. . __ .. r.. . . . ' ~ . ' Y , ~ . . . ' ' . . .. ~ . , , .;prox'imal end X34 of the firing connector 432 rotatingly engages" tha distal' end ofthe . , , . . .
:i~ . ; ~eta1 drive bar.140:(FIG. 6): The distal end ofthe.firing;connector'432,.includes'a , F. ' i ~ . . ' slot X36 flint receives a proximal end 43 8 .of the firing bar 14, attached therein' by;pins ,.. .. , ~ w :~; , ' ' ',,. ° .. .
k . . . : ,(nct .shown): : . .
. ' ~-i ,- . , , , ' , .
. . :.
.4: 4 out:
. on~gl ~ ' . ~~ more distal portions of the firing bar 14 extend through the.fraFne. .2 . ..
t , . : .. . . ..
' . ; ~thrc~gtna widened slot 440, guidedy on eaoh lateral s'ide,by the resilient support section , ;. , ~:q,~"; ~ p~cular, flexible right half and left halves 412,.444 :each include a proximal ~ .. , . ...:
I ' ~ that are insertable into the widened slot 440 of the frame:424. , Defined into . .
. . gab 44 , y '': .'the opposing faces. of the .two flexible halves 442, 44.4 'of the ~esi;lient.,support section : , ar 'de 448 and a c lindrical rod recess 450 that xeceives a ~exible ;
A.22 is a firing b . gui Y
, ; ._: _._ . :'. .'. ,~.' .: . 4 .4 which is en a ed vvith a distal~recess 456 formed ~ ,' y rod X52. A rigid guide member . 5 ,, g. g . .
:into the' distal faces of both flexible halves.442, 444, includes a veztical slot 458 . ; -.~ .w. . ; .. : .
.oa 'ed by ~a cylindricalhole 460 Iortgitudinally aligned to receive respectively the , _ 1 , .
pp~ : '. : . . '' .' yring.bar 1:4 arid the.flexible rod 452. ~ . . . ' . , .: . , ' ..
el; aacliorin l~ features 464.that I~'tao~9~ ' - Aaarticulating fra~ae membei 462 has charm , , . . .$ ' ~a~~ ~ $ttachment. collar 4d6 of a proximal portion in the elongate channel I
6,.:
~.x . . . ' . ~: .thering bar i4 parsses through a lower slot 468 in the articulating frame member , . ..
. , . '.
. . x,62: ~ The articulating frame member 462 is spaced away from the distal_end of the . . . . .
resilient support section 4Z2 by being attached to a distal end. 470 of the ft~xible rod' ; , '-,'. , ' , , ~ ~~45a,.' ~ereb ,,wthe elongate charmel 1 f is. attached to tl~e;handle portion 20, albeit vv~itli . ' ., :.
Y.
i~. .; . ' . . . ..
. , a f3e' ible portion for. articulation motion therebetween: 1 . .
. ~ . ' .' ,.,. ', .. :':':,,. . '.
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. . :: :: ' : . ' ~ : :.:...:~.. .:.. :.:.. .~.
v ~ : ~ _..__ __.._ . . ~a,., w. w.~,. ..,~ r,~ ..~r . .~-~ ...~~~..E.~~ ---- ~ ~..~.~.n..". ~_.-~-.~.----m------ ..... 3 a '. .' f . ,..
v ;w .: ~ , w ja~6oj : ' The elongate chan~ael 16 also has an anvil cam slat 472 that pivotally receives . an anvil,pivox 474 of the anvil 18: The closure ring 4t~8 that en~compssses the:,frame .
'~~ ~ ~> 424 includes a distally presented tab 478 that engages ~n .anvil feature '478 proxianate but ,distal .to the anvil pivot 474 on the anvil 18 to,ther~eby .effect open,i~g and closing '~ :~ _ :aft~eanvil'18._ ~: ~. .. . : : , : .. .w:..
tcoarl ' The. articulation drive tube 404. encompasses ~tf~e frame 424 and is distally. .
vattached to the bevel gear section 402, which in turn encompasses.
the'proximal tabs ~4~6 ~~of the #fexible right half and left halves 442, 444. 'The bevel;
gear',section 402 .
~enmjeshes'~with the bevel spur gear 406 of the closure ring 408, as depicted in FIG.'~1'~. .
"~~'he~closure tube.416 is distally attached to the pivot conaectioi~:414~,.which in turn :,:v .- v ;. :, i, .. ,,presents distally projecting and laterally opposing tabs 480,,482,that:pivotally.attach. ~
v . ~ ~°.res ecti~re ~~ t4 ivot points 484, 486 of the closure ring.
4f)8.. : . ; . , ' , . _ ~ .. ..~ .'. ~ . ,. , ~ . ::,; ~.~. '~:: :~.,y.:,.
', lcosal ~' I vL~X=NECK ARfICULATTON MECF~M ~ ~
. .,~ , . , ' . , ; . .
taos~l ~ FIGS.. ~18-19 depict~ a. flex-neck articulation iuechanism 5.p0 for.
the surgical instzument;' I O of FIG. 1 that also employs a rotational articulation motion about the ~ ~ ~ . .
,longitu.dinal axis to~effect the articulation of amend efi:ector. I2 ~(not depicted im fiIGS:
.. , , :: .. ~ , . 'lg-1'g), Unlike lmowa fle~c-neck articulation mechaaisin, the rogation articulation , ..
:ic~otion provides a.smooth and continuous positioning capabslity<
~. , . i_ ~ . ' ~ v, loosal .. . In particular, a resilient flex-neck body 502 includes a firing, bar slot 504 . .
'vhro~gh its: longitudinal axis to receive the firing bar i~4,.(not depicted in FIGS. 18-19).. , ., . ; ' . , ' ..,. ~ . ~ .'-~4 sezies of pairallel right-hand and left-hand slots 506, .508 projecting inward iu. . . . . . .
ti ~ . o the left' and ri '- t "r 'op~poisite direction into the flex-neck body 502 enable articula, ozi t .
~ , , t a endicular'to the firing bar slot 504. Right-hand arid left-hand cylindrical passages ' ' .P iP ; . . . . '- . ~ ''. v : . , . , .. - : . . ~ S 10,'512 are offset from the longitudinal axis of the flex-neck. body 5.0~. and .tee ~ ~ d',fins 514 516 formed formled respectively into the resulting right-hand dad left-hen t.... . , ~ . .. ......
. ~y ~e~ ~~t .hand and left hand slots 506, 508. , . . . . . . . . , ~ .
i ~ : : : v:
y :' ~ : .
,: tooss~ . j , A distal face 518 cf.the flex-neck~ body 502is located at the.most distal of fhe . . ' ' rightlhaad arid :left-hand ins 510, 512. Distal face 51.3 includes gear ccnaection :. . . ' . .
'. . ~ ~ . ~ ea ~ at~ilities to convert the rotational. articulation motion.of xight-liand and left-hand' . - .. . . _ .
_ . p ; . ~ ' : . ... ~' ,.
articulation tubes, depicted as threaded rods :520, 522, into arx articulation motion.' ';.y;. . . '.' - . '..: i _. . , . ~,, '., ., :. i . . ~ ' ~ . ~ . . i . . . , . ~ , ~ .. -. ' , ~ . . . .. ' ' , ~ ' v ~ ';
~; ' ~ .
'_. ~ w' ' ~ ~ ' -19~ v . . . ;. .,. .',~,., ' . ..'.._, .... : ',' .-. ~~ 1 '.., - ~ ' . ::.; .. _ ~ . ' : .. -: . . ; _ ., . . ~.. ;_ . , , r. 7 ; , ; ,~ . ' :. v.. . .' ' ....b_..,~. d_"-~._-.~a_.~,m._.m_.~...~.We.~~,._._A__,.=~.~,~ ~. .~.._~- ~.. -~-----_-~- --~-_------._..._ __.__.__.
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S~~cificallj!;
threaded nuts 524, are attached to ea.ct~.side respe~ctively.on the 'distal.
face 518..
In the 111iySt1'atlVe.VerSion, each tl3read~ed nut 524, 526.includes a pair '' ~ ' . ' ~f 1$terallY
P~)ecting pins that snap respectively :into griPPing finEers~
53.0 to prevent rotation of threaded nuts 524,526.
When the.tbreaded.nuts 524;526 are tz'~re~ed iti the same direction, such as left.
hand or right hand threads,:
the threaded -rads and must be rotated in opposite directions to articulate the flex neck .
.
.
bod~
502.
As, threaded rods 520, are rotated, in opposite directions;
ane nut 524, :, ',moves proximally and one nut 524,526 moves distally..
~'he proximally moving '.nut 0l~
shortens the portion of the threaded rod 516;
~:.proxunal to the .
.
t , ~threacled nut 524, 526, thus compressing the.corresportding,right-hand or left-hand ..
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Coos41 !
~PERATiON
.
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A
closed end effector and shaft of an im~plemenx p~rtion Z2, of a surgical tap ~~ing and severing instrument are inserted through a caaxnuta passageway.of a .
. ~tracsr to a surgical site for an endaseopic or laparosco;pic procedure.
The articulation !W corst~ol is rotated as desired about the longitudinal .axis of the shaft to effect a r...
~~correspondirig rotation of the end effector 12.
Advantageously, the.actuator lever a~culation control is pivoted to create a rotation articulation mofion about Q
f ~, l the lbngitudinal axis of surgical instrument l0 in ari articulation.drive.tube 200, 242,, j520 that is converted into an articulation motion ,~.t.a geared connection in an .
, , ' ;..
~xcy~lation meclianism 11, 240, 370;
400, 500, thereby,positioniizg the cad effectar , , w.. t2 a 8esxred~position.
~
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.
, While the present invention has been illustrated by description of soveral ,, , ' ~mbodimerits and while the illustrative embodiments lave.been ~escx'itied,in ' considerable detail;.
it is not the intention of.the applicant to restrict-or izi any way .
...' lirriit !the scope of the appended clauns to such detail.
Additional.adyantages and ..
, inodi,~cations may readily.
appear to those slcilled in the art..
.
v. a~~s ! ~
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t ~
For ~exarrtple, the present invention has been duscussed in terms of endoscopic ;
i procedures and, apparatus.
However;
use herein of.terms such as,''endascopic', should.
' not be constniect to:
limit the present invention to a surgical stapling and severing ~
, .
unstntmetrt , . '.; for :j : use :. only - ;:.. :~:' in '.: conjunction ~ with :l: an endoscopie tube (i:e., trocar).
On the,..
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therapeutic :effect (e.g:, endocutter, jasper, cutter, s~taplerss clip applier, access c ' ~ device, druglgene therapy delivery device, and energy device wing ultrasound, RFC
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Positioning the end effector is constrained by the trodar.::, generally these erid~scopic ~ surgical instruments include ~a long.
shaft between tlxe end effector and a ~
;
. .
;y ~ .,:., , t;.
l~,ndle po"rtion.manipulated by the clinician.
This lon~,shsf~
en~blesvinseriiowto a ' . 7 , . _desi~red depth and rotation about the longitudinal axis~of the shaft, thereby positioning ahe.
end effector.
to a degree.
With judicious placement bf the trocar and use ofv r . . ~$rassPers, for instance, thraugYi another, tmcar, often 'this aznot5.nt of positioning is :
. ,. . ' . .
. , ,'. su~,,~cient:
Siu,gical stapling and severing instruments,-such ~as described in U.S.
Pa;:
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5,465:,895, arc an example of an endoscopic suigical irtstiv~ent thrit successfvIl' .positions _. , . . an ' end effector by insertion and rotation.
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More.receatly, U.S.
Pat:
Serial No.
, v'SIJRGiCAI:
STAPLINCw.
~~
L~TSTRUMENT
INCORPORATING
AN
E-BEAM
FIRING
MMECSM"
to ' 8h~~ton et al.,., filed on May 2003, describes an iruprovedv."E~eam"'.fining bar for.
' ' .
, ' ~ .
severing tissue and actuating staples.
Some of the.additional adyaritages include .
' . ' ~ :
affi~natively, spacing the j aws of the end effector, even if elight~y too much or two .
. a: , , littlje tissue is clamped for optimal.
staple formation.
Ivtoreover, the E-beam firing bar ~
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includes en~a.gesahe end elector and staplt cartridge uz a way that enables several .' .
' . ' ' ben, eficial lockouts to be incorporated.
' . . ~ .
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; Depending upon .the nature of the operation, it may. be desirable ~ tb further gdj~st.the.positioning ofthe cad effector of an eadoscopicsurgical instrument. In ' ' particulaz, it is open desirable to brient the end affector ~at a~, axis transverse to the ~
' .
..
. :_' ~' longctudiizal axis of the shaft of the instrument.
The transversemovement of thd'end_.
eff~ctor.
. :~' relative.
to the instrument shaft is conventionally refeaed to as "articulation"..
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This articulated ositio ' ermits the clinic' ' .
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tan.to more easily engage tissue iuaome ~
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instances such as behind an organ.
In addition, articulated positioning y ad~aatageously ~' . allows i; an ; endoscope to ~be positioned behind the end effector without , .
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' ' . , _ , . , . : r T ~ ~ , .be'~g blocked by the.
instrument shaft.
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Approaches to articulating a surgical stapling.
end sev~erirrg instrument tend .
be~icompueated liy integrating control of the articulafiorc along:vvith the contmi of ...'.:..~y ;
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;closing the end~effector to clamp tissue and fire the end effector,(i.c., stapling arid 'sev ring) within the small diameter constraints of an endoscopic instruzrrerit. 1. ~ y ;Generally; the #hree. control motions are all trarisferr~l..through the-shaft as. . ~ , , lori~itudinal translations. For instance; U.S. Pat. No. 5,6 i',3,84a :discloses an . .
' :a,ccordion:Iike articulation mechanism ("flex-neck") that .is articulated by selectively , dravi~ing back .one of two connecting rods through'the.imp~lemerit:~shaft, each rod offset .
' :respectively on opposite sides of the shaft centerline. The: connecting rods ratchet ~ .
' ah~ough a 'series of discrete positions. ' . . .
. ~ ,: .. . . : ; . ; : .. .
.; tooogj -~~ Another example of longitpdinal control of an articulation.
mechanism is U.S.. ~. . ' . . , , ' , : : . ~ , ~jPat.'No.. 5;865;361 that includes an_articulation lick offset :from 'a camtnirlg pivot:~sucls, th.atipushi~g.or.pulling longitudinal translation afthe yticalatioii link,e~'ects ~ ~ ~ ~ ~ . .
.:articulation to~la respective side. Similarly, U:S. Pat. No. 5,797;537' iscloses a similar ~ ~ ~ ~, , :: , ;, , '.~ , : ; ~,:. ~ .., . ~., ~, .;; , , : ~~~~, ~ough . . to effect articulation. . . : , . . , , , ' ' rod the shaft ; ~ . ' . .
laoo,9Z . ; ~ ~ While.~these longitudinally controlled articulation ~echa~usrns have provided- ~ _ .
. ;., . ; :: . : .: : ,. , ,, , , .: certain advantages to surgical instruments such as for:endc~scopic ~stapluig and ~ , ' .
~sev'eriag, it is believed that an.alternative articulation moti~~ri.would provide~additional''~ ~ ~ .~
.:, .: v': .':.~ ~s: v,, . ;, . ~ . .~ y.des~git ~le~cibility. v v . ~.
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i LL.S, patent No. 5,405,344 teaches an endoscogicvsurgical instrument.that, in ~. ~ ~ .
the embodiment (shown.in FIGS. 7-I3); uses rotary motion abot:.t the longitudinal axis .
' to articulate the end effector of the instrument in a conical motion. A~,s taught, the .. ~ .
. r . ~~..articulatitig.end effector uses a ball (convex member .1'74) :~ttaotied to.the end,effectoi ~ ~ ~-: arid a sockeE in a distal end of the hollow support tube'16~: .A
Hollow shaft 188 is' .;,,~ , ~ ': : bent into s"Z°° shape. and has a diatal portion 198 that is bs.~.t to farm: at an angle to :.~ r .' ' v.
=';.. - ; . . . .. .
.: .. ~1~.. 'v the ~loagitudi~al axis. Distal portion 198 is ratatably mounted:within a passageway . .1 ' .' v ..
' . ~' ~ ' 1r7~ extending into, the ball or convex member 174, of the etid effector., ~Nhea tk~e' ~; ~ . . ., . ~ , ~ ., ~: y,stal portiow 198 is bent to the same angle as the passageway ~'~8, the end effector. ' ~ ' ..
' ,' ~ ho~dw'shaft 188 can be assembled (ib one position) aligning the:loagitudinal axis ., ' , .. . '~ : r . ofthe,end effcctor with the hollow shaft 188. Rotation of,the ldollow shaft 188 from y ~, ~ ~ ~ ' thi$ .alignment position articulates the end effector in a. conical motion. As sho~i~in. , , :~ .: :.:: . F~~rS 10.13, ;the end effector both translates and rotates.
relative to the. longitudinal , ~ ° , ~ ~ . ~ ' , 1. ; . ~ . ....
. . : _ .l : ~ : ;,' . ails., : Vl?hil~ providing articulation,, the conical motion is not, intuitive and re_ quiies , ' .
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f depicts a side elevation view in section, of a hanc'~1~
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pro~tirnal end of the 'surgical instrument ofFIG.
incYudiag a rc~tatiag articulation ~
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v depicts a perspective, exploded view ,of the haadle portion of the ', ' ' pro~iinal . ~ end ~ of the,surgicai instnunent of FIG.
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;...~.v , ~ 8 ' :depicts . a ~ooaoj perspective ~ view looking do~w~virard;:
forv~ard:
aad to the right :.
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, , , portion of the surgiceil iinstr~ineat of FIG.
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partially.;
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.f a,'!~.$tsl portion Df the handle : ~ , ' vcut~a'~vay to expose a rotating articulation.control mechanism.
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'depicts a perspective view loolsiz~
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and to the right of .
. , . portion of the handle portion of FIG. 8, partially cutsw~y . .. '~~ to expose the '-~
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- ;rotat~g articulation contml mechanism and have,a rotating articulation -~' . .:i , y , ', , : y .
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depicts a top perspective detail viei~r of a spur, ge'.sr.articulation.
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frame , ' ,~:_v. :~ ~ . '' owed. ~ : .~' : '. . " : : ~. .. '_.. ..
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, . i FIG. 11 depicts a perspective, exploded view of an implement ...~ . portion of the ' . .. . . .
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including a spur gear articulation ~riechanism.
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ooth articulation ~, , FIG.
l2 depicts, a front perspective view of a snsggl,, t , .
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. i FIG. ,13 depicts a top plan view of the anaggl~-tooth axticulation ~. . i?~azy~ asechaaism. cf . , , ' ,; ; . ; .:" , 1 ::
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~: ~ ~! FIG.14 depicts a fronts perspective cutaway view of.a dual.worm-gear : v'~r ' .
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depicts a side perspective cutaway,view of a..bevel-gear articulatton -. i ~
i mech~anistrt far the surgical instrument of FIG.
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~: ~ . ' , ~ ~ortion of the : ~too3?~1' . ' t FIG.. l6 depiots a perspective, exploded view of as implement ~ : p ' v ~
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~ s~ , . ' , ; w ~ , ,~aL~instnurleat~of FIG..1 including the bevel-gear articulation mechaaisxn of.FIG: ,.
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sleeve, and firing portions.
lao3~l ' FIG. l8.depicts a top view of a dual and flex-neck articulation mechanism for he surgical instrument of FIG. 1.
,' r (oo3s1 FIG. ,19 depicts a front perspc;ctive view of.the.duaL rod flex-neck articulation, .
.; . ~.' . , :mechanism of FIC'r. 18. .
. ..
.' Iaet~'ited I7escrit~.tfoa of the Invention ' tooa~l Turning to the Drawings, wherein Like numerals demote like components ' ;throughout the several views, FIGS. I-j depict a surgical instrument, which in the :illustrative eri.~bodiment is more particularly a surgical stapling and severing .
' 'irlstt<ument~ 10; that is capable of practicing the unique 'benefits o~f the present ~ ~ ,. , invention. In particular, the surgical stapling and severing instrument,10 is sized.for. ~. .
insertion, in a nonarticulated state as depicted in FIG, ;L, through a trocar cannula , , : , ~y~sageway to a surgical site in a patient for performing a surgical procedure. ~nce .. . . ..
,an,ai~iculation z~nechariism 11 and a distally attached eyd effectar.l2 are inserted '~~~ ~e caunula passageway, the articulation zztech.anistn l l..may,be remotely. .
varticulated; as.degicted in FIG. 2, by an articulation control 13. Thereby, the end,' . ~ ' effl;Gtor. I2 .rnay reach behind an organ or approach tissue from a desired angle o~. foi .
' othez reasons. For instance, a firing mechanism, advantageously depicted.
a's an E-beam firing bar 14 .(depicted in FIG. 3), that severs ,clamped tissue, engages an ' ' ~.elorigate channel 1.6 and a pivotally attached anvil 18.
'.'. , . . ; i ... "
'~' too3~1 ~ Tl~e surgical~ and stapling and severing instrum~,mt 10 incxudes a handle portion, .
i ~ 20. c!onaected ~to an implement portion 2Z, the latterfurther comprising a sliaft'23 .i~ ~ . ~ . ' . ' ' i , . , . . . . . . ; " , . : ~ ' ~ . , -dist,~lly terminating in the articulating mechanism 11 and the anti effector 12. The . , . , .
)~an~t~ partiOn 20 includes a pistol. grip 24. toward whi~;h a cr~sure trigger 26 is . .
~ .
pivritally drawn by the cliziician to cause clamping; or ~losiag, of the anvil 18 toward:
~~ ': the .olong~te channel 16 of.the end effector 12.. A firm trigger:28 is farther.~utboard ' T . .. ' : ~ i ~ . ~ . . . ., ' of tl~.e closure trigger 26 and is pivotally drawn by the clinician to cause.the stapling' , .,. ;~' ., y . .,:.. . : ', ,. ! -. .
y ~ ~ : , k : . ~ . . . : ' ' : , ,: ~' . i , '. .: '..:. 'i. ~ ? . '.
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y, ~ ~ _ and severing of:clamped tissue in the ~d effector 12. Therea~er, a release bufitpn 30 . , , is dep'iessed, to:release the .clamped tissue. . .
, ioo3~1 ~ An outmost alasure sleeve 32 of the shaf1~23 Iorigitudinally trauslatee in i ... . . I . .~ r ~ . . . ~ ~ . , . , ..
r ' , ~ respprise to the .cis~stue trigger 2b to pivotally close the anvi'1 18. Specifically, 8 distal ~. j . ~ ~ . '~ .
potion, or closure ring 33, ofihe closure sleeve 32 with respect to the articulation , , v ~ rnech~nism ~1 I is indirectly supported'by a frame 34 of. the. i~apl~ent portion 22 w.i ~(~~ally visible~at the articulation mechasrism 11): ,.At the articulation ~echanisrin 1;~1, , , .aproxialal portion; or,closure tube 35, of the closure sleeve 32 cotninunicates witl= the ~ .
~s~~' onion (closure~ring) 33. The frame 34 is flexibly attachedto the elongate ~, . : ~~ . . _ . .~,; , chl 16 via the articulation mechanism I 1, enabling; articutatia~a in a single plane.
T'he fame ~4 also longitudinally slidingly supports a fiixang dr~.vc tnembex 36-that '.
~cor~unicates .a firing motion from the firing, trigger 28~ to the f ring bar 1.4. ,Only the , . ' ,. , ; . . : ..,:.
_ . . ~~ 14~of:the firing drive rrte3nber~36 is depicted FIG. 3, but:the.f~ring drive y raerizber 36 is described below iurthei detail with regard~to varriou~s versions of a iota~onallycontrolled articulation mechanism 11. . , j . . . ~ ~ '.
. .!: : ~ : 'EC~;,3~1 ~,~ . . ~ : ~ .It will be appreciated that the terms "proximal" and "distal" are used herein a ,, ; ; .. , ~ .. .
with deference to a clinician gripping a handle of an irnstiu~me~nt. Thus, the end , . , ~ - . , r effec~nr 12 is distal with respect to the more proximal Handle portion 2Q.
It will lee .
nY. '.. , ~, ~ . i ether appreciated that for convenience and clarity,~spatial~ termssuch as "verrtical"
.:j . . .. k . ;,. : ..~ , , ,, . ' ~d "~orizontaf.' are used herein with respect to the cirawings~ .However, surgical .
. .h . _ - , . , ' .
ents: are;usod in many orientations and~positions,' and these terms are not ~
~ .
.,.. I . t :.. ... ; , , . ~ , ~ ~
>;~ .'.._,,. : :;:.y;: .'.;. . , : i~.ter~~led.to?be limiting and absolute. , , . : , ' ,1 I , : ..::.:
I. i I
y , , . ,, . .. . . , . .. , , ,. toa~m~: . ~ ~ E-BEAM~ FIRING BAIL . .
,. , _ ' , : .. .. ~ , r : . ~ , ~:~ . :~ . : y : . ....:' ,_ :: .;;;::,:::':
E~a411 ! ; FIGS.. 3:-~. depict the end effeetor 12 employung the.E :bears firing-bar 14 to :,perform a number of fmactions. In FIG: 3, the firu2g bar 14 is proximally po,sitian~i,: . . .
alto .' ..an . eat staple cartridge 37 to be installed~into,the elongatd channe1~.16. . .
g . , . , , .. ~e~~ ~ wr ~ in 38 of the filing bar ~I4 xesides yrittuzl a recess, depicted as: : '' ~ ~ .
In p ~ . . upp P , . , . .
~vil ockef 40 alto~ivin the anvil 18 to be repeatedly opened:=and. closed, v Withvhe ~ ., .
are. ate P .
:~ff~ta~ closed-as depicted in FIG. 4, the fuing jai 1,4 is advanced°in engagement, .' . .
. ~ . . : .- . .
~, .with the anvil 18 b having the upper pin 38. enter a longitudinal=anvil ~slot 42: ~ A
,. ~'. v . , . ~ y . . . , _. . .. . .. ~ ~ .v ..
v lows xr~ost pin, ~or firing bar cap 44, engaged a lower suiface of the elongate :channel ~ , _ .
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. ~ .:- ' lb by having.the firing bar 14 extend through a chann~;l slot ~5. ;A middle pin 46 . $lidingly, engages a top surface of the elongate channel.'16,, cooperating.
with the firing ~ ;
~i ~~. c~ ~. Thereby, the firing bar 14 affirmatively. spaces .the end effector 12' dining firing, .overcoming pinching that may occur with a nzirumal amount of clamped tissue . ' ~aiid overcoming staple malformation with an excessive; amount of clamped tissue:
~' ao~i burin firm a distail resented cuttin ed a 48 between the a er in 38 ( ! g ~ Y P g g PP P .
! and riziddle pin:46 of the firing bar' enters a proximally presented.vertical slot 49 of the' , staple cartridge 37,. severing tissue clamped between the staple 'cartridge 37 and the anvil! 18. A;s .~shovvn in FIG. 4, the middle. pin ..46 actuates.tJze Maple c~Gridge.3'7.by t .: ~ . , entering into a firing slot within the staple cartridge 37, driving a._wedge sled 4I. into . ;
;.
upward carisming contact with staple drivers 43 that in turn dnvea plurality of staples ~~,out of staple apertures 51 in the staple cartridge 37 i~ato forming coatact with staple ' dockets 53 'on ari inner surface of the anvil 18. FIG. 5 depicts the firing.bar 14 fully ' r' distally traz3slated afrer completit2g severing and stapling tissue. v .' lo~4sl t TWa-AXIS HAIi~LE
(opal, , i With reference to FIGS. 6-7, the handle portion 20 is comprised of first.and y second base sections. 50 and 52, which are molded froxd a polymeric material such as, a glass-filled. polycarbonate. The first base .section 5,0 .is proyided.witlz a plurality of y cyluidrical=shaped pins S4. The second base section 52 includes a plurality of . y , ' , .~xter~ding. tirien~bers 56, ,each having a hexagonal-shap~;d opening, 58.
The cylindrical-. . , shaped pins 54 are received within the hexagonal-shaped openiygs S S and are a. . . , .. ... i . . .:
frictionally~held therein for maintaining the first arid second base';sectioas 50 and 52 , , ' : ~ tn assembly. , . ~ .':
' , ..
Eoa4~j', .. ; .~ A housing cap b0 has a bore 62 extending comf Ietely through if far engaging ~d rptating~ the implement portion 22 about its longitv;dinal axis.-, The housing cap 60 . , includes an, inwardly protruding boss 64 extending along.,at least a portion of the bore , .
~Z, 'fhe protruding boss 64 is received v~iithin a longitudinal slot,66 formed at a , . ~1 proxirnalportion of~the closure sleeve 32 such that'rotation o~~the.housing'cap 60 _'.b,:.~ ~ . . .~ .. . . . , . . . . ..
appreciated that the.boss 64 further effects Totation'af the ctosurc sleeve 32. It will be .. ~ ~ .~~ . : . . ~. .
extends through frame 34 and, into contact with a portion of the fi~ing~drive, member , ;, w,;. ; . ~ . :, ... ; ~ '~ . v : : ,, .
. : . .. :.
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CA 02473512 2004-07-09 ..E
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. , ~,6 to ;effect their rotation as well, Thus, the end effecto;r 12 (not shown. in FIGS. 3.4) rotates with. the housing cap, 60. , . .
'~(oo~ A proximal end 68 of fhe fra.-ne 34 passes proxinxally. through the housing cap .' . , , ,6.0 .and is provided with a carGUmferential notch 70 that is engaged by opposing - ' -~ _ ~ : . ~ .c;~anriel s~ctuemei~t. members 72 extending. respectively from the ,base sections. 50 and 5~'2: Only the.charmel securement member 72 of the second base section 52 is shov~m.
r The channel securement members 72 extending from the base sections 50, 52 sense to secure the frame 34 to the handle portion.20 such that the frame ~4 does not move . a, . . . , longitudinally relative to the handle portion 20. .
. :. toa4~la ~ .. i Therclosure trigger 26 has a handle section 74, a. gear segment section 76, and;
. , , ~ . , "' :.
an intermediateysection 7,8. A bore 80 extends ttlrtough;othe intermediate section78. ,A, .
.:;-~. : . .... . . ,, - . - .
e~rlincirical support member 82 extending from the second base section ~2 basses . . . , '' ~ - t'"brough therbore 80 for pivotally mounting the closure tri$ger.26 øn the handle ;.
i t . _ ~orti~n 20. A. secaac~ cylindrical support member 83 extending from the 'second base , $~~4n 52 passes; through a bore 81 of firing trigger 28~ for pivotally rriounting on the.. , l~aiidle portion 20. A hexagonal opening 84 is,provided in the cylindrical support , , . , . ' : m~b~ 83for-receiving a securement pin (not shown) extending- from, the first base .; i ',; '. , ; , - ~.;;.,: ~ .' ' ~ ., section 50, v , , ' : . .' .
Eo;,~sl. ~ A closure yoke 86 is-housed within the handle portion~20 for reciprocating- ~ ~ - .
. . .,, ~. : ~ . . ..
movensent therein and SeNeS to transfer motion from the closure trigger 26 to the' , ' ~, : . ~ i . . ' ~ . : ~ . ' ' ' closure sleeve 32. Support members 88 extgnding froth the second base section ~2 y . .
.. . . ..
' . and, sccure~nent member 72, which-extends through a recess 89 in the yoke 86, . ~ - ' supp.ert the yoke 86 within the handle portion 20. ' , -~ .
- ~ ~~ (~~sl , ' ~ A.l~x~ ~ gQ of the closure sleeve 32 is ptnvided with a flange 92 that is, . _ ~. . . .
snap ~fitted'into.a receiving recess~94 formed in a distal ~.nd 96~ofthe yoke 86. A~, ;
: ; :. proximal end 9,8-of the yoke 86 has a gear rack,100 that is ~ngagod by the gear j ' ~segnient seerioa 76 of the closure~trigger 26. When the-closure trig$er:~6 is moved:
~ istol. 24 of the handle onion 20, tha,y~ike 86 aid, hence, the closure-. ~.
tawa~rd.tb.e p . . grip P . ~ . :
.. ~ : sleeve 3Z' n~rove distally, compressing a spring 302 that~biases the.
yoke 86.proxitnally:
.' ~:d' ~:' . ,-'4 :'' ~ . .. I . . ~ . . ~ , . ~ '. ~ ' .
. ~isxal movement of.the clo.sura sleeve 32 effects pivotal translation movement .of the'.' . , w. ;' ~ ; . . v; ' ~ . : ~. . .. ' .. .. . ; .' ., . :'_~
.; ,. .. - . ~ - y . _.. ~ : ,. .
' ~ ~ . ' ~ ~ ~ ' .
'. . : . , ' -. ~ . .
.. , i ~ . L ' .. . . ' .: .
. . '. . . ' ~ . : ~ .' ' ' ' ,. : . . . ' . ~ ' ~ ' . . " ': . .' ' ~.' , ; ' ,, .
' . 4 ~ _ , . , l .y .. .: ._. ' ~
}: .,. :.: :. ~. . . .. .. ~ . .. . .
anvil ~ 8 distally and toward the elongate channel 16 of the end effeetor 12 and, ' ~ ;
proximal .movement effects closing, as discussed' below.
1.. ~ ., ! 1 ~oo~~~ ~ ~ The closure trigger 26 is forward. biased to ari open.positiQn by a fFOnt surface . ': ~ ~' 1 ~~ interacting with an engaging surface 128 of the firing trigger 28. Clamp first .~
'w . . ~ ~ ~ hook 104 theft pivots top to rear in the handle portion 20 'about a pin .106 restrains ~~ aioverrient of the firin tri ~ er 28 toward the pistol grip ..24 uatii the closure trigger 26. ;, , _ . g gg . ~ ~ ~isclsr~,ipzd to its closed position. Hook 104 restrains fzting-trigger 28 motion~by engaging a lockout pin 107 in firing trigger Z8. The hool~.104: is ahso in.contact with ., >y. , .. . ;. ;
,tpie cldsure trigger 26; In particular, a. forward proj ectiora 10S of.the hook 104 ~~ ~ enga~s-a member 110 on the untermedtate section 78 of the closure trigger 26, tha . ~ ~ rriember 110. being outward of the bore 80 toward the handle. section 74.. ~Hoo~ ,104. is.. - , .
. ~ ~ , .: . . . . . . _ biasef towaid'contact with member 1 IOQf the closure trigger 26 aiid engagement, with ~.
,'ldeko I t is 107 in firing trigger 28 by a release spring l i 2. . As. the closurearigger 26.. ~: . : .. .
. . ~ P . , : . . .
,~I ~~ F ~ . . . ' '~ .. ' : ! is depi~ssed; the. hook 104 is moved,top ~to rear, compressing the release spring 112. . .:: .. ,.
;, ~,~ is~captured between a rearward projection 114 on the; hook 104 and a forward ~ , ; ~ ' . ' .. ~ '.. :v:_.
. ,pro~ec,~ow 116 on the release button 30. : . ' , v':,,',~, :;~: ,.;:, ';,~ ; -';.;,. . ,. ~,. , . . , , ,, ~ ~ :
lao~y ~ As the .yoke :86 moves, distally in response to proximal tnavemeat of the : ~ .
cosine trigger 26, 'an upper latch arm 1 l 8 of the release button° ;3Q
moves glong an ..
°u~per'surfaoe 120 on the yoke 86 until dropping into ari upwardly'presenced recess, ' ~. i ' -. ' ., .
,1~2 iti a .proximal, lower pbrtion of the yoke 86. The release spring 1 I2 urges the . . .
. .release button 30 outward, which pivots the upper Iatch~ arm 2,18 ,dov~mwardly into ;y .: ~~; n, .. eti ~a 'ement vvith the a wardly presented recess 12Z, ttteiceby~ Locking the closure ' , ~ ~ . ;
,gg .. P
ey 26 iri~a tissuo clamping position.
.. gg~ ;. . . ,' .. . ..
.
.., ' . " i The:Iatch arm 118,can be moved out of the recess 132'to rel~ase.
the anvil 18 , ' .. ~ , .
yy p~~g :~e release button 30 inward. Sgecificall'y, the ugpei~l'~teh arm 118 pivots. .
upward about,pin 123 of the second base.section .52. The yoke 86 is then peimittedao' . . . ' . .
~wmove~ roximaliy in response to .return movement of the closure trigger 26.
. ,, .! P , : . . . , . ; : '~ ;
~A fiiriag: trigger return spring 124 is located within the handle portion 20 with .
i:: ; tocs3'; ~ . . , y ~ ~' ~' one~,.ehd. attached'to pin 146 ofthe second base section, f2 arid the:-othervend attached ~' ..: I : . . , , '. to a pm 126, on :the firing trigger 28, ~ The firing return spiW g 1~24aPPlies a retuxn . . .. .
.. i . . . . . . . ..: , . . .. . . . . .
' force~ta the; pin 12b. for biasing the firing trigger 28 in a direction-away from the pistol., '.
' .. ' ... ~~. ' . .. i .a , : . ' : -: ~ . : ' . .- I 1- ,. ' : . . _ . , . : ~' .. ~ .. , . r~.. v . w : ~' w.. . _ . ; , : ,.,,, . ' : v: :;,'... ;..
',.,,: . ,' ..., .. ~ :, . .;. . ; ; .: . ~ . ~ .. - . : .,, ,,:,.,:,,~ .. ,;
:. - . .;..
I ~..~-. ~....
'. :. . . : .... : ,: . . ; ~ ~ . ' ~ .. ~.. :; . . ~. . ',.
grid ~4 of the handle portion 20. , The closure trigger 26 is also based' away from . pistol grip 24 by engaging surface 128 of firing trigger ~28 biasing frost.
surfac.8 .130- o#' g yosure tri er 26, $ ' ' toos~l~~ ' As the closure trigger 26 is moved toward the pistol g~=dp ~4, its .front surface .
..'. . . - ~ 1'30 engages with' the engaging surface I28 on the fuin,~ trigger 2$ causing the fuing . ' ;.
'. ' ' triggey 28 tc move ~to its "firing" position. When in its fuing position, the firing. , . .
:: . . . ..
dagger 28 is. lpcated at an angle of approximately 45°'to the pistol grip Z4. After ..
' ~ ' stapled firing, the.'sprirtg I24 causes the firing trigger 28 vto return'ta its initial position. ~ , . : n ~.~ 1 . . ' i. , Du.~ing the xetum movement of the firing trigger 28, its engaging surface 128 pushes .
'f''. _ . ~ :against the front surface 130 of the closure trigger 26 causing'the closure trigger 26 to:.. , : .
... , i ~ its ' ~'tial asition: A sto member 132 extend3 from the ~secorid bas s~
~'ori ~ . ' v v ~ return to . uu P P . a ech ,. ,. . , '. ':c : ~ . ~ 5~ ~toyrevei~t.the closure trigger 26 from rotating.beyond its.initial position.
~,~ ; ..f :,'~ :y . . ,.., . ,.. ~, , ' ., ,.,; , ,, i ., . . . , . . . ~ ; ~.
. y . v .
. : ta~ssj. ~ ' The stugical stapling and severing instrument 10' additionally includes a . ~ ~ . . .
a:..: , ~ ~ . .
r~cigr~cating section 134, a multiplier I36 'arid a drive yeniber I3~8, , The . .
' !: ~ ~ ~ ~ ' r~ciprdcating section.I34 comp~.ses a wedge sled, or viredge,sledin the implement .
Y ~, .' ,. . v, , I . - ; _ . .
.. pp~o$~ as (not shown in FIG. 6-7)~arld a metal drive rodwi40.
5~ ~ ~ , foossl ' ~ ! The drive member 138 includes fast and second gear.Taclts 141 and '142. A
. . . ..:
. '. fixst nptch 144 is provided on the drive member 138 intermediate the first and,second . .
gear,rachs 141, 142. During~,ret~.~rn movement of the firiyg trigger; 28, a tooth 146 on , ttie'friag trigger 28 engages with the fast notch 144 for returning the drive member ~ : .
.1~8 to its. initial:position aRer staple fuing. A second. notch 148 i~~
located at a . . : .
. . ..
proximal enii of the metal drive rod 140 for locking the Enetal driive rod 1A~0 to the , . . , v upper hatch arm 118 of the release button 30 in its unfired position:
i. . : . . ,.
' ; ~~~~1 ~~ The multiplies I36 comprises first and second integral pinion gears I50 and :152. The first integral pinion gear 150 is engaged with.a. firsi gear,.:rack 154 provided oa themetaldrive rod 140. The second integral, pinion gear, IS2 is~ engaged with the .
v fii'st~gear rack 141 on the drive member I38. The first integal;piriion gear 150 hasva r.... . ~ :.. ~ ... , . .
' . : fast d~ametez, atrct the second integral pinion gear 152 has. a second.
diameter hat. is... ~ .' '';~. :.. ~' ".'. ~.. '. . r.sa~alketr~thsnthe'firstdiameter, ~ .: , .:,. y ;.:.. ,,,:" ..,,.
. . ioossl .; . .. ~ ROTATIONAL ARTICULA?ION CONTROL. .
.' . . ' : . ~ ., , , - .'... . .
' ~ ~ _ ' . ; , ' . , . ,, .: :a: :.: : ~' .: , .. , . .. W~.' :;.. : ..~. ~ ~ : ..:. .. ' v. .-:y. . . .
.... :..
j . . . ~ ; , ._..' ~i ~~ , , s , ~ : ' . , ' , , loons? r, With reference to FTGS. 6-9, the handle portion 20:adva~tageously .
incorporates the articulation Control 13 that both rotates; the .irraplement portion 22 about the longitudinal axis df the surgical instrument lf) aad articulates the end effec~or I2'to an angle with the lonoitud~nal axis. A ho:llow.articulation drive tube 200 ' . i : _ .
is coucentzicaily''Iocafed within the closure sleeve 32 and is operably coupled to an actuation leuer 202 such that rotation of actuation lever 2:02 rotates tube 200 about the ' ~ _ ' ;
longixudinal axis and causes perpendicular rotation or a;rticulatxon of the closure ring .
. . . : '.
250 and end effector 12. This articulation of the closure ring ZS.Q, corresponds to the degr ie and direction of rotation of actuator lever a02 vi'~wed. ~.nd :manipulated by.the:
'' c?~inioian. I~ the illustrative version, :the relationship is one to one, with the d.eg~ee of rotation of the actuator lever 202 corresponding to the d.egree..of ~rticuIation from the .longi~uiiinal axis ofthe shaFt 23, thus providing an intuitive indication to'the clinician.
yt gill be appreciated that other angular relationships inay,be~seleeted.
C ~ ... ' ~ .I . ~ _ .. ' ~. . . " . , . ~ ' r v 'fa~6ol ; The~artiEUlation control 13 includes a, pair of mirrored articulation . .
.tradsmissiori'housings 204 that are attached to the housing cap 60~.
lVtozeover, the ; ' ' . .
articu~ation,trangmission housing 204 includes longitudinally ~hgned external Tabs i 206 that a chisieiaa twists to effect rotation of the articul',ation transmission housing.
;, 204; and thus,.of the. end effeetor I2, about the longitudinal axis of the implement v portian.22 The actuator lever 202 is attached to a cylindzical articulation body 208 ;
~~~ aIsides within a' cylindrical recess 210 opening .generally upward and pen~..e~dicular to the shaft 23. The lowernosf portion of the articulation body 208 , irlciudes prongs 212 that snap &t into an opening 214 in the. articulation transmission . . : :, '' housing 20~ naar to the shaft 23, the;pxongs 212 grevent:ing the articulation body 208 ~:
from being withdrawn from the..cylin.drical recess 2I0.
' ~ ' y :,.. _ . ' ' ~o~~tj ~ , ~ Azznularly presented gear teeth 216 are located about t~,e lower:pomon of the , ,..
,~ atliculation body Z08 and mesh.with teeth 218 on ari arr~culation yoke 220 The ' aa,'ticu~ation yoke 220 straddles an articulation recta~ngul,~r wiadow~222.forinedyn tie ' .
~ ~closur~ sleeve 32. Closure sleeve 32.is slidably moveal~le.witl~izii the articulation , ' control 13 (in the longitudinal direction)'. to close and open the ~nci effector 12. 'The ;.; axticu~ation drive tube 200 moveslongitudinally with the closure sleeve'32 relative to: .
I.
the fined articulation coatrol 13. 'UVindow 222 provides ~Iearauce~for a boss 224 ' .
~, . ; . ..
~nvciar~ily presented from the articulation yoke 220 that pusses through the rectangular ' :.. , : . .: _ . i, :. ', '.. , v.
_ ; ,.
.. . -'I3 -. i . i ' . ' . : . . ~..:
'1 , <;
y ' ,, . . .. ~ ; ~ ~' ~ . ' : ' :. , ' . . : .~ ' ' . : ., . :
~wi~idow 222 to engage a slot 226 in the articulation drive tube .20Q, longitudinally . .
;ypositionirig the articulation drive~tube 200 for rotational motion:
.Thehollow ~' ar<icuiation drive tube 200 extends.longitudinally within the ~clasure sleeve 32 from,'.::
..
' ., _ ;
~rthe articulation mechanism 1 x cad terminates distally.befose the locking tabs.2271.of ~. . . . .
. :ahe closure sleeve 32. The tabs 227 are inwardly bent behind the proximal face of the . . .. ' ..
~~articulatio3~ drsve tube 200 and thereby retaining the ariticulatioa drive:tube 200 n the ;shaft 23'. , .. .; . ' , . . _ 1. : , , ; :~. -. ;. . :_, y ,. : , :....,y . ~ to~os~~ ~ It should be appreciated that the articulation tra~nsmissioa housing 204. is , /. E operatively associated to the closure tube 35 of the shaift 23.
Th~:housing cap 60:
:: ~. ~ ~ . . w . ~.
.. ~ ~etaius the~articulatiori yoke 220:in the-arCiculationaraasmissian.~ousirrg.204 and: . . , .~
.~etaitss the :articulation control I3 within the handle portion .20 by presenting , pro~mally~ an outer diameter circular groove 228 that, engages a circular inward lip . , . ..
. .. ; : , . . ~ . .
' ' 230 at the distal opening of the assembled base section:a 50,, 52. ;1 ~ .
. ', . ,..
.' ' , , v . . ..
;,:, . . ' ,~ (~os33 . , ~ FIGS. 10 and 11 depict the gear articulation rnachaaisa~
11. of FAGS: .1-2 in .the .
~o~of a spur.gear articulation mechanism,Z40, which is gesaerally the same nay : .
desc~i'bed.above but.with a,dditioria3 articulation driving; eorhpanents ora:.the other side. , . ~' bf the attioulation mechanism 240 to thereby iacreaee perinrmanGe..
Articulation :. ~ . ., . ;
r~: .; - . . ~ . ~ ' r r ' m~ ' 'sue 240 has a rotatable hollow articulation driun tube .24~ that is ,: . ~onc'~ritric~lly 1'oeated within closure sleeve 32 and has a.
distally:projecting gear :. , :y,:,...,.:~: : . . . . . . . . .'.
section 244 about a, first circumference portion 246. Gear seetion 244 meshes with a ,' ' ear 248 attached to and ro~tirr~alP ro'ecting from elosure:=ing 250 which .. ;
. : . .
. ~ 'spur g . P Y P 7 . , :.1 ~ pivots about pins 253 extending through first and second pivot paints.
25Z, 264 . . ~ ' . .
.~ ~ ' . re actin distall from the closure sleeve 32. Thug, an, articulatipn pivot axis passes w'. . ~ .
P ~ g . Y ~ ,.", through both the first and second pivot.points 252, 260:and pins X53 ratatably couple ~~
w' . .:
. : .. _ v ~ . _ ~ v closuxe ring 250'to 'the closure sleeve 32. Rotation' of drive 342 eau~gages, the gears 242.' ~~ .
d..~$ 'cad articulates closure rin 250 about first. and ~ecoad pivot points 252, 26Q, y'' g ; . . ,,' . ',. ' ; ; ~ ~ . v:
yoo6sr:' ~~ . . ! 'fo. inc~~ase the.effective surface area of gear contact-bttv~een.the hollow _ _. ~ '. :. . .
' .;articulation:drive tube 242~and the closure ring Z50, a s~:coad~Circumferenae;portion : , ~.
. ~, . , .254 df the hollow articulation drive tube 242 has a recessed dnta~ly projecting gear .~ . , :: .. . ; . _, section 256'extending therefrom. Gear section 256 is operably coupled to a,second . , .. . . . .
~, spur gear 258' attached to and proximally projecting frptn an opposite lateral side of ' I . ~. .
. ;.. _ ~ ._. ., r14~ . ' ,, : ',,.
. v: .y ' . . . . :. . : : . ~ . . . ~ ': w.
,;.,', .'.-.:..: .. .'.. .: :.'~. .. . . . : .~ _.:. -, .: . ':. . . ... . .
... ,..': ,. ..~:
......_ ..~......,...... .__ .......... ...~m.._ m~.._.._m.~, ~.n..w,~~~""~..~~-~:~~.~...~~...._-..._.. .... ~ __ F. i ~ i t.p.
the closure.ring 250 by a reversing gecr 262 pivotally supported.by the. frame 34.
.. , , > , Reversing gear 262 engages both the recessed distally projeetm~:gear section 256. on one side arid the second spur gear 258 of the closure ring 250 ~n the other.
iaos53, . ~ When ttie closure trigger 26 is actuated, both tile hollow articulation drive ube ,. 242 surd pivotally attached closure tube 250 of the cloeuso sleeve..32. are moved _ , ~~st~~Y to close the'anvil l8. 'The closure tube 35 of thE;. closure sleeve 32 is spaced .
away;frorn the closure ring 33'by pivotpoints.252, 260 pinned to:pivotvoles 2G4 and . : ~:~g centered in: spec gears 248, 258, , and a frame opening 268 that ~exterids 'tneretnrough. .The frame opening 268 provides clearanc;e.so that, the p~oximal'edges.:
of W a closure,ring 3.3 and the. distal edges of the, closure tube;.35 .of the closure sleeve . ' . , ~ .
;_; . ~ ~ 32 do~not collide. during azticulation. . : ~ . , ' , . , ~ , ', ~oo~~ ; FIG: I I depicts in disassembled form an implemverit .portion.2'~d, that includes .. .
' . tbe~spur gear articulation mechanism 240. A frame 272 is.Iorigitu~i~aaily attachable'to ' 0 icted in FIGS. 1 and 2 with a. .bushiri 274 on its . roximal : ~. . . _ . .
..
heha~.dle,portion2 (dep . ) ~.y: p, ; . ~,'.~.: .'.y.., ~.:' end fqr rotatingly engagement thereto. A frame trough':~76,farmed by an opening 278.
longittidir~a.lly aligned with the center of the $ame. 272 is longer t~an~a firing . . .
' ~
connector 280 that slides longitudinally within the. framitrough 2'7.6. The proximal . _ .
'- end o~ the firing, connector 280 rotatingly engages the diistal end of the metal drive bar 1~0 .(depicted in FIG 6). The distal end of tile firing eoiuxectQr 28~
includes a slot X82., ta,~°Lat receives a~ roximal end of the firing bar.l4,.attached therein by pima 284: .A.
,, . , p ,; ' more .distal portion of the firing bar 14 is positioned within a lower', groove 286 in a , . .
fizing'bsr slotted guide 288 that is distally engaged with an attioulating .frame.memb~r ;, 290 , , . ' . . . ' . .
and the,;frame 2.72. .
i , ' v. .
. X006?~ ~. i Articulating fraiae member 290 has a channel=anchoring member 292 that .
distah~ attaches.to an attachment collar 294 of a proxiWal portion in the elongate. . . . . , ., .
cliann~l 15. 'The firing bar I4 passes through a lower slot 295 in the;articulating .
frame !member 2g0. . The articulating frame member 290 is spaced. away from the.,. ~, distal I~nd of the. frame 272 by the firing bar slotted guidle 288 and~~flexibly attached ' . ~ thereto. for aiticulation .by a resilient connector 296'. . A ~r~idened ,pi'oximal end 298 ctf . , . the resilient connector 296 engages a distally. communicating top recess 300 in the .
. : ..i v .. ;; ~. , distal end ~f the'frame 272 and a widened distal end 30~ of the resilient connector 296 . . .
v... 4, e_ . , ', : . . ; : :,.
a.... . ~ . ~. , :. ~ y , ' ~ ... ~ y - ~., : ... ...:.:
15 . . : , ; , ~ ,. ,. . ,, ; .;,.,"..
~ .: _ .. . y ., . ' : : . . : .. . ;. . . . .. ., .
'.. ~ _ _. .._ . .. ~..,. _ ~' .. _ , _ w CA
t ~,.....
~~
;
:~g~ges a proximally,communicating top.recess in, the arxic~latiag frame member ~29(~
Thereby, the elongate channel isyttached to &xe handle portion 20, albeit with . a f~exible portion therebetween.
~
_ (oohs) ;
1"he elongate channel l6.also has as anvil cam ;slot 3Ob that pivotally receives Iart .arwil pivot of the anvil 18.
The closure ring that encarnpasses the r : that engages an .
articulating frame member includes, a distally pres~~ted tab .. , ~nvi~
feature proximate but distal to the anvil pivot on t3ie anvil to thereby 'effec't opening: , When the closure ring Z50 is moved fc~rwa=d, its distally presented ~ g face 31'4 contacts a tamped cylindrical closing face 31 G, ~los':which is distal to tab, ~ , f the ~rivil 18. This.canuning action closes the a~rvil 18 downward o tmtil the . , , closir<g face 314 of the closuie ring 250 contacts a flat .cylindrical faoe.318 of the anvil: : , . . . , .::
,IB. , . . . ~ ~.
.
, . ,"~. s, :y , ,, ~, ~':;':, . AGGLE TOOTI-I ARTICULATION MECfLANIS1~I ; . .:.~ . . .
.:.~.
v.. .._ tva69j SN
' .
(0001 ' FIGS, 12-13 depict an alternative articulation mechanism 350 for the surgical: . , stapling and severihg instrument 10 of FIG. 1. A snagj~le gear conaectiou 352 is . , l forzriring a50 (not ~ed therein by positioning a: single spur gear 354 oi" a clnsure I
depicted in FIGS.
I2-I3) to .the longitudinal axis of the:
closure ~g 250:
The snaggle gear . . connection, is completed by slanted teeth formed at a distal end of a .
:
.
~
.
I
.
;
~lus~a'tubb 360.
Pairs of slanted teeth slope towftid each other registered to one side ~f the :spur gear with other pairs of slanted, te~ah slop~g toward the other .
_ ' .
:
.
, , side ofahe:apur gear 354.
This sr~aggle'gear connection achieves a high gear ratio ~, . , -r .~,y~~a elatively large degree of articulation for a givea~a amowat.,of rotation motion ' ; ' ~tiott~
the longitudinal axis by the, closure tube 360.
It should be appreciated that a , various types, of interconnections between a shaft and .an eud eff~ctor may be each dace 4f the spur gear .
.
.
.
positiohed around the articulatiomnechanism or about .
, .
.
.
,;
:
:
.
,.
.
.
, , _ .
,i ,;..: ~
(ro?i ,.
.
:
.
.
..
WOR1~I
GEAR
ARTICULATION
MECHAN1:SM
I
;. ' (oa~ag :
.
~
~
, .
~.
'.
.
~
, ~
~
~
'FIG.
depicts a worm gear articulation mechanism 370vfor the.,surgical I
' , k stapling, and.
severing instrument of FIG.
1.
A, clos~ixre iing is depicted p~attially .
.cutawa 'to, ~
ose,two articulation 374, 3?6, each off~~et laterally from the y , 'r r y:
v v ~.
!
' ~
n: ; . , ;
.
j .
.
.
~, .
r =
/.
, .
.: ; . . .; ~, , .
:.:
, >
.
~
'.
.
, ' .. ' ,:.,~ ~ i.;' . . . ., ' ! ~, , ~ ~ .
.lonmi'tudinal.axis of a closure tube 378. The closure ring 37yis.~ivotally carmected at ,. :v.- . ' ~...- i ~ , ..
pivot' points 380, 382 extending from the closure tube 378, the pivot points 380, 38~ ' ' ' defining a pivot axis, A, concave face spur gear 38~i of hourglass.,shapc is aligned .. vvit~.the~pivot axis and attached to the.closure ring 372. Concave face spur gear.384 is pi~toting about an interzral pivot point 3S6 distally projecting fromyhe closure tube;, ' ~ 378. ;Each articulation drive. tube 374, 376 includes; worm gear-teeth 388 , . ~ , eaca~passiag at least their distal portions that enmesh with oppnsite.,sides, of the '' ~ eoncave~face spur gear 384. Thus, by counter-mtating.the two articulation drive tutzes _ ' , ''3?4, X76, about the longitudinal axis, the closure iiag 372, and thus the end effector.. .
32: (nPt shown in FIG. 14) is articulated.abaut the pivot axis. ~
... ~ '.
(oa~3~_ . .~ ~ rt will be appreciated that only one articulating drive~.tube::374, 376 maybe .
Hsed.' In advdition,.in plication wherein a cavi 390 for a aria ~ bar I4 is not .~y required, ~it v~!ill be appreciated that the concave face spur gear. 38;4 may be centered ,, '' ian~ahe pivot~axis rather. than offset as depicted. Moreover, valthough a concave' face of Hourglass shaped spur gear~384 achieves a large context area with the articulation. ' ~ . drivetuhes 374,' 376; straight or other shaped-faees may be:
used:..F'urthermore, the c articuilatiori drive tubes 274, 376. may be solid or hollo'v. .
~~6~aj~ BE~EWGEAR ARTICULATION MECHANISM . , ,; , . .;, . , _ . ~ . :.
~ :~too~sl FIGS.' 15-17 depict a bevel gear articulation.meGhanism 4'00 for~the surgical ' stapling and~severing instrument 10 of FIG, 1 that also produces articulation from rotation of a member about the longitudinal axis. Tnsteact of a~hieviag greater ~ ~ ~, r~-ngth in.the..gear connection by inclusion.ef a reversing gemr; an.aggle tooth gear, or.
V . ~ .. ' '' 'I . . . , . ' .~ .. , a worm gear.type of connection, a bevel gear section 402 is,provided that is coupled ~ . , , - . , ' . . ' . ; ~' ,. '' ~ ~ ~ ~ . . ~ '. .
.. ~, . . ~ : to a;-~ iartieulstion drive tube 404. In FIG. 15, drive tubs 404:.is' shown sectioned xo ~ ~ , shov~ri elements within. Bevel gear section 402 of tuba 404.iaeshes with a bevel spur ~esr 405 ~foirtned from a closure ring-408. ~ . ~ . ~ .
., . ~ ; :' ., . ~ ':
aao~sl With~particular reference'to FZG. 16', an implenaent portion. 410'is d~gicted hiavit~g additional advantages, such as the bevel gear articulation mechanism 400 .
. , ~ -. iaclueling attachable portions, specifically a pivot conrAecticn 4I4':attd the bevel,gear : ~ . , ~ ' , :o; ~ . ' :. . v ~e~,an 40Z;~that are riot formed respectively into a,closure aiibe 4:16 or.the articulation . ' ' ...
Q.~wc~tube 404, whereby simplifying manufacturing processes why facilitating a shat , ~~
. .. , i ~ . ' .' . ' . . ~.:. . ; .'..~'.. , ~'.\ ~J~~'':4n. ~ ~,.v.,~l, ~'.. :.W. . : y ~ ~ ' ~ . : . ~ . ~ . - ., ' ~ : ' ~ . ... : ~ ' "~.' .. ~.' ~' ' ,.
i v , .. : : ~ I7 ~ ' ' :~ : , ' .. ', . . _. .. . . .::' . ' ,, , ; ;
' ~:
.. ~;.' ''. ,: '~ , . ' : y ,: ~ : . y ~' . v ' v': . : . ...:..~ ~' ; ;
t .. . , . _ :-f, , n . ', . . . , ... . .., . . .
r ' ':. 418 of selectable lengths. In a3dition, the assembly of the. b..evel gear section' 4Q2 tn ~a separate articulation drive tube 404 allows fox a constriction 42Q inside'the bevel gear section 402 to be confined to only that portion of;the shst~ 4Y S adjacent to bevel gear . .1 ' , sec~ioit 402. ;, . ~ ~: . ~ ,;:
~'~ ' " ' too~~j : ~ Azesilient support section 422 couples a frame 424'distally to the end effector ~
f . ' ~, '. . . ..
. ~ . ' I2 through. this constriction 420. A proximal end 426 of the'frame 424 i.$ - , .
longitudinally positioned to the handle portion 20 (not depicted;in FIGS.
15:17) for- .
irotatingly~en~agement thereto. A frame'trough 428.fornied by ari.opening 430 . .
', ~ . '.longitudirfally .aligned along the longitudinal axis of the frame 42~
is longer than a ' I ' . . . , .
,:firing conaector.432 that.slides Ioagitudinally within the frame trough 428.. A
: '!. . __ .. r.. . . . ' ~ . ' Y , ~ . . . ' ' . . .. ~ . , , .;prox'imal end X34 of the firing connector 432 rotatingly engages" tha distal' end ofthe . , , . . .
:i~ . ; ~eta1 drive bar.140:(FIG. 6): The distal end ofthe.firing;connector'432,.includes'a , F. ' i ~ . . ' slot X36 flint receives a proximal end 43 8 .of the firing bar 14, attached therein' by;pins ,.. .. , ~ w :~; , ' ' ',,. ° .. .
k . . . : ,(nct .shown): : . .
. ' ~-i ,- . , , , ' , .
. . :.
.4: 4 out:
. on~gl ~ ' . ~~ more distal portions of the firing bar 14 extend through the.fraFne. .2 . ..
t , . : .. . . ..
' . ; ~thrc~gtna widened slot 440, guidedy on eaoh lateral s'ide,by the resilient support section , ;. , ~:q,~"; ~ p~cular, flexible right half and left halves 412,.444 :each include a proximal ~ .. , . ...:
I ' ~ that are insertable into the widened slot 440 of the frame:424. , Defined into . .
. . gab 44 , y '': .'the opposing faces. of the .two flexible halves 442, 44.4 'of the ~esi;lient.,support section : , ar 'de 448 and a c lindrical rod recess 450 that xeceives a ~exible ;
A.22 is a firing b . gui Y
, ; ._: _._ . :'. .'. ,~.' .: . 4 .4 which is en a ed vvith a distal~recess 456 formed ~ ,' y rod X52. A rigid guide member . 5 ,, g. g . .
:into the' distal faces of both flexible halves.442, 444, includes a veztical slot 458 . ; -.~ .w. . ; .. : .
.oa 'ed by ~a cylindricalhole 460 Iortgitudinally aligned to receive respectively the , _ 1 , .
pp~ : '. : . . '' .' yring.bar 1:4 arid the.flexible rod 452. ~ . . . ' . , .: . , ' ..
el; aacliorin l~ features 464.that I~'tao~9~ ' - Aaarticulating fra~ae membei 462 has charm , , . . .$ ' ~a~~ ~ $ttachment. collar 4d6 of a proximal portion in the elongate channel I
6,.:
~.x . . . ' . ~: .thering bar i4 parsses through a lower slot 468 in the articulating frame member , . ..
. , . '.
. . x,62: ~ The articulating frame member 462 is spaced away from the distal_end of the . . . . .
resilient support section 4Z2 by being attached to a distal end. 470 of the ft~xible rod' ; , '-,'. , ' , , ~ ~~45a,.' ~ereb ,,wthe elongate charmel 1 f is. attached to tl~e;handle portion 20, albeit vv~itli . ' ., :.
Y.
i~. .; . ' . . . ..
. , a f3e' ible portion for. articulation motion therebetween: 1 . .
. ~ . ' .' ,.,. ', .. :':':,,. . '.
~ e', . ~ ' . , ' , ' . : .. ~ , '..s, ~r . : : '- ~ il ~ ~ ~ ~ : . ~ . ' . , . . . . __ ; ... ~ ~. ~, ', '~: .
.v. . .. , . t . . . . 'v ' . .- ~ . ~ .~ :._, :i ... I8 ~ ,,, ,. ..;,_.~~..::
. . :: :: ' : . ' ~ : :.:...:~.. .:.. :.:.. .~.
v ~ : ~ _..__ __.._ . . ~a,., w. w.~,. ..,~ r,~ ..~r . .~-~ ...~~~..E.~~ ---- ~ ~..~.~.n..". ~_.-~-.~.----m------ ..... 3 a '. .' f . ,..
v ;w .: ~ , w ja~6oj : ' The elongate chan~ael 16 also has an anvil cam slat 472 that pivotally receives . an anvil,pivox 474 of the anvil 18: The closure ring 4t~8 that en~compssses the:,frame .
'~~ ~ ~> 424 includes a distally presented tab 478 that engages ~n .anvil feature '478 proxianate but ,distal .to the anvil pivot 474 on the anvil 18 to,ther~eby .effect open,i~g and closing '~ :~ _ :aft~eanvil'18._ ~: ~. .. . : : , : .. .w:..
tcoarl ' The. articulation drive tube 404. encompasses ~tf~e frame 424 and is distally. .
vattached to the bevel gear section 402, which in turn encompasses.
the'proximal tabs ~4~6 ~~of the #fexible right half and left halves 442, 444. 'The bevel;
gear',section 402 .
~enmjeshes'~with the bevel spur gear 406 of the closure ring 408, as depicted in FIG.'~1'~. .
"~~'he~closure tube.416 is distally attached to the pivot conaectioi~:414~,.which in turn :,:v .- v ;. :, i, .. ,,presents distally projecting and laterally opposing tabs 480,,482,that:pivotally.attach. ~
v . ~ ~°.res ecti~re ~~ t4 ivot points 484, 486 of the closure ring.
4f)8.. : . ; . , ' , . _ ~ .. ..~ .'. ~ . ,. , ~ . ::,; ~.~. '~:: :~.,y.:,.
', lcosal ~' I vL~X=NECK ARfICULATTON MECF~M ~ ~
. .,~ , . , ' . , ; . .
taos~l ~ FIGS.. ~18-19 depict~ a. flex-neck articulation iuechanism 5.p0 for.
the surgical instzument;' I O of FIG. 1 that also employs a rotational articulation motion about the ~ ~ ~ . .
,longitu.dinal axis to~effect the articulation of amend efi:ector. I2 ~(not depicted im fiIGS:
.. , , :: .. ~ , . 'lg-1'g), Unlike lmowa fle~c-neck articulation mechaaisin, the rogation articulation , ..
:ic~otion provides a.smooth and continuous positioning capabslity<
~. , . i_ ~ . ' ~ v, loosal .. . In particular, a resilient flex-neck body 502 includes a firing, bar slot 504 . .
'vhro~gh its: longitudinal axis to receive the firing bar i~4,.(not depicted in FIGS. 18-19).. , ., . ; ' . , ' ..,. ~ . ~ .'-~4 sezies of pairallel right-hand and left-hand slots 506, .508 projecting inward iu. . . . . . .
ti ~ . o the left' and ri '- t "r 'op~poisite direction into the flex-neck body 502 enable articula, ozi t .
~ , , t a endicular'to the firing bar slot 504. Right-hand arid left-hand cylindrical passages ' ' .P iP ; . . . . '- . ~ ''. v : . , . , .. - : . . ~ S 10,'512 are offset from the longitudinal axis of the flex-neck. body 5.0~. and .tee ~ ~ d',fins 514 516 formed formled respectively into the resulting right-hand dad left-hen t.... . , ~ . .. ......
. ~y ~e~ ~~t .hand and left hand slots 506, 508. , . . . . . . . . , ~ .
i ~ : : : v:
y :' ~ : .
,: tooss~ . j , A distal face 518 cf.the flex-neck~ body 502is located at the.most distal of fhe . . ' ' rightlhaad arid :left-hand ins 510, 512. Distal face 51.3 includes gear ccnaection :. . . ' . .
'. . ~ ~ . ~ ea ~ at~ilities to convert the rotational. articulation motion.of xight-liand and left-hand' . - .. . . _ .
_ . p ; . ~ ' : . ... ~' ,.
articulation tubes, depicted as threaded rods :520, 522, into arx articulation motion.' ';.y;. . . '.' - . '..: i _. . , . ~,, '., ., :. i . . ~ ' ~ . ~ . . i . . . , . ~ , ~ .. -. ' , ~ . . . .. ' ' , ~ ' v ~ ';
~; ' ~ .
'_. ~ w' ' ~ ~ ' -19~ v . . . ;. .,. .',~,., ' . ..'.._, .... : ',' .-. ~~ 1 '.., - ~ ' . ::.; .. _ ~ . ' : .. -: . . ; _ ., . . ~.. ;_ . , , r. 7 ; , ; ,~ . ' :. v.. . .' ' ....b_..,~. d_"-~._-.~a_.~,m._.m_.~...~.We.~~,._._A__,.=~.~,~ ~. .~.._~- ~.. -~-----_-~- --~-_------._..._ __.__.__.
CA
,. ~'.
~~
~
,, , ..
' -: , _ - , , ' , ,. , ".
S~~cificallj!;
threaded nuts 524, are attached to ea.ct~.side respe~ctively.on the 'distal.
face 518..
In the 111iySt1'atlVe.VerSion, each tl3read~ed nut 524, 526.includes a pair '' ~ ' . ' ~f 1$terallY
P~)ecting pins that snap respectively :into griPPing finEers~
53.0 to prevent rotation of threaded nuts 524,526.
When the.tbreaded.nuts 524;526 are tz'~re~ed iti the same direction, such as left.
hand or right hand threads,:
the threaded -rads and must be rotated in opposite directions to articulate the flex neck .
.
.
bod~
502.
As, threaded rods 520, are rotated, in opposite directions;
ane nut 524, :, ',moves proximally and one nut 524,526 moves distally..
~'he proximally moving '.nut 0l~
shortens the portion of the threaded rod 516;
~:.proxunal to the .
.
t , ~threacled nut 524, 526, thus compressing the.corresportding,right-hand or left-hand ..
' , lots sos, Los:
..
' i ' .
:
.
.
.
, .
' ' .
Coos41 !
~PERATiON
.
:.
~
. 1 ' FoGS~ ~
~
A
closed end effector and shaft of an im~plemenx p~rtion Z2, of a surgical tap ~~ing and severing instrument are inserted through a caaxnuta passageway.of a .
. ~tracsr to a surgical site for an endaseopic or laparosco;pic procedure.
The articulation !W corst~ol is rotated as desired about the longitudinal .axis of the shaft to effect a r...
~~correspondirig rotation of the end effector 12.
Advantageously, the.actuator lever a~culation control is pivoted to create a rotation articulation mofion about Q
f ~, l the lbngitudinal axis of surgical instrument l0 in ari articulation.drive.tube 200, 242,, j520 that is converted into an articulation motion ,~.t.a geared connection in an .
, , ' ;..
~xcy~lation meclianism 11, 240, 370;
400, 500, thereby,positioniizg the cad effectar , , w.. t2 a 8esxred~position.
~
; toossl y ,;
I
.
, While the present invention has been illustrated by description of soveral ,, , ' ~mbodimerits and while the illustrative embodiments lave.been ~escx'itied,in ' considerable detail;.
it is not the intention of.the applicant to restrict-or izi any way .
...' lirriit !the scope of the appended clauns to such detail.
Additional.adyantages and ..
, inodi,~cations may readily.
appear to those slcilled in the art..
.
v. a~~s ! ~
i. .
t ~
For ~exarrtple, the present invention has been duscussed in terms of endoscopic ;
i procedures and, apparatus.
However;
use herein of.terms such as,''endascopic', should.
' not be constniect to:
limit the present invention to a surgical stapling and severing ~
, .
unstntmetrt , . '.; for :j : use :. only - ;:.. :~:' in '.: conjunction ~ with :l: an endoscopie tube (i:e., trocar).
On the,..
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Claims (22)
1. A surgical instrument, comprising:
a shaft configured to independently transfer an actuating motion, and a rotational motion about a longitudinal axis thereof;
a handle portion coupled to the shaft operably configured to produce the actuating motion and the rotational motion;
an end effector responsive to the actuating motion; and an articulation mechanism responsive to the rotational motion to articulate the end effector in a plane from the longitudinal axis of the shaft.
a shaft configured to independently transfer an actuating motion, and a rotational motion about a longitudinal axis thereof;
a handle portion coupled to the shaft operably configured to produce the actuating motion and the rotational motion;
an end effector responsive to the actuating motion; and an articulation mechanism responsive to the rotational motion to articulate the end effector in a plane from the longitudinal axis of the shaft.
2. The surgical instrument of claim 1, wherein the end effector comprises a stapling and severing mechanism, wherein the actuating motion comprising a longitudinal firing motion and the stapling and severing mechanism is further responsive to a longitudinal closing motion, the handle portion and shaft configured to produce and transfer the firing and closing motions.
3. The surgical instrument of claim 2, wherein the shaft includes a closure member responsive to the longitudinal closing motion and pivotally coupled to the end effector, the shaft further includes a firing bar and a frame supporting the firing bar figured to transfer the firing motion to the end effector, the articulation mechanism including an articulation drive tube communicating the rotational motion to the pivotal coupling of the end effector.
4. The surgical instrument of claim 3, wherein the pivot coupling comprises a pair of distally projecting, laterally opposed posts extending from the closure member respectively coupled to a pair of proximally projecting laterally opposed pivot points extending from the end effector.
5. The surgical instrument of claim 3, wherein the articulation mechanism comprises:
a means for pivotally coupling the end effector to the shaft;
a gear means for converting the rotational motion of the articulating drive tube to an articulation motion of the end effector.
a means for pivotally coupling the end effector to the shaft;
a gear means for converting the rotational motion of the articulating drive tube to an articulation motion of the end effector.
6. The surgical instrument of claim 1, wherein the shaft further comprises an articulation drive tube responsive to the rotational motion from the handle portion and distally terminating in a gear section, the articulation mechanism comprising a spur gear proximally attached to the end effector and engaged by the gear section.
7. The surgical instrument of claim 6, wherein the articulation drive tube further comprises a second gear section proximally recessed with respect to the first gear section, the end effector further comprises a proximally projecting gear section laterally opposite the spur gear, the surgical instrument further comprising a reversing gear engaged between the second gear section and the proximally projecting gear section.
8. The surgical instrument of claim 6, wherein the gear section and the spur gear form a bevel gear connection.
9. The surgical instrument of claim 6, wherein the shaft further comprises an articulation drive tube communication the rotational motion to the articulation mechanism, the articulation mechanism comprises a spur gear proximally attached to the end effector, centered on the longitudinal axis of the shaft, the articulation mechanism including slanted teeth converging on each side of the spur gear.
10. The surgical instrument of claim 6, wherein the shaft further includes a counter rotating rod offset from the longitudinal axis and the rotating rod, the counter rotating rod and rotating rod enmeshed to opposite sides of the cylindrical gear.
11. The surgical instrument of claim 10, wherein the cylindrical gear has a concave face.
12. A surgical instrument; comprising:
a handle portion operably configured to produce a rotational motion;
a shaft having a longitudinal axis and comprising:
an elongate frame attached to the handle portion, an articulation drive tube encompassing the elongate frame and responsive to the rotational motion, and a gear section distally projecting about at least a portion of a circumference of a distal end of the articulation drive tube;
an end effector pivotally coupled to the shaft at a pivot axis; and a spur gear on the pivot axis, proximally attached to the end effector and engaged to the gear section to convert the rotational motion of the articulation drive tube to an articulation motion pivoting the end effector from the longitudinal axis of the shaft.
a handle portion operably configured to produce a rotational motion;
a shaft having a longitudinal axis and comprising:
an elongate frame attached to the handle portion, an articulation drive tube encompassing the elongate frame and responsive to the rotational motion, and a gear section distally projecting about at least a portion of a circumference of a distal end of the articulation drive tube;
an end effector pivotally coupled to the shaft at a pivot axis; and a spur gear on the pivot axis, proximally attached to the end effector and engaged to the gear section to convert the rotational motion of the articulation drive tube to an articulation motion pivoting the end effector from the longitudinal axis of the shaft.
13. The surgical instrument of claim 12, wherein the articulation drive tube further comprises a second gear section proximally recessed with respect to the first gear section, the end effector further comprises a proximally projecting gear section laterally opposite the spur gear, the surgical instrument further comprising a reversing gear engaged between the second gear section and the proximally projecting gear section.
14. The surgical instrument of claim 12, wherein the spur gear is centered on a longitudinal axis of the end effector, the gear section of the articulation drive tube comprising slanted gear teeth converging on each lateral side of the spur gear.
15. The surgical instrument of claim 12, wherein the gear section of the articulation drive tube comprises a beveled gear section, and the spur gear comprising a beveled spur gear.
16. The surgical instrument of claim 12, wherein the articulation drive tube further comprises a second gear section proximally recessed with respect to the first gear section, the end effector further comprises a proximally projecting gear section laterally opposite the spur gear, the surgical instrument further comprising a reversing gear engaged between the second gear section and the proximally projecting gear section.
17. A surgical instrument, comprising:
a handle portion operably configured to produce a rotational motion, a shaft having a longitudinal axis and comprising:
an elongate frame attached to the handle portion and an articulation drive tube offset from the longitudinal axis of the shaft, responsive to the rotational motion, and including a distal, exterior threaded portion;
an end effector distally and pivotally coupled to the frame at a pivot axis;
and a gear connection offset from the pivot axis and the longitudinal axis of the shaft and engaged with the distal, exterior threaded portion of the articulation drive tube to convert the rotational motion of the articulation drive tube to an articulation motion pivoting the end effector from the longitudinal axis of the shaft.
a handle portion operably configured to produce a rotational motion, a shaft having a longitudinal axis and comprising:
an elongate frame attached to the handle portion and an articulation drive tube offset from the longitudinal axis of the shaft, responsive to the rotational motion, and including a distal, exterior threaded portion;
an end effector distally and pivotally coupled to the frame at a pivot axis;
and a gear connection offset from the pivot axis and the longitudinal axis of the shaft and engaged with the distal, exterior threaded portion of the articulation drive tube to convert the rotational motion of the articulation drive tube to an articulation motion pivoting the end effector from the longitudinal axis of the shaft.
18. The surgical instrument of claim 17, wherein the gear connection comprises a spur gear aligned with the pivot axis having a gear face offset from the pivot axis and aligned with the articulation drive tube.
19. The surgical instrument of claim 17, wherein the gear connection comprises a spur gear aligned with the pivot axis having a gear face offset from the pivot axis and aligned with the articulation drive tube forming a worn gear connection.
20. The surgical instrument of claim 19, wherein the gear connection further comprises a second articulation drive tube engaging an opposite side of the gear face.
21. The surgical instrument of claim 19, wherein the spur gear includes a concave gear face.
22. The surgical instrument of claim 17, further comprising a resilient member coupling the frame to the end effector, and a second articulation drive tube offset from the longitudinal axis opposite to the first articulation drive tube and both distally passing through the resilient member to respective threaded connections.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/615,973 | 2003-07-09 | ||
US10/615,973 US7111769B2 (en) | 2003-07-09 | 2003-07-09 | Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis |
Publications (2)
Publication Number | Publication Date |
---|---|
CA2473512A1 true CA2473512A1 (en) | 2005-01-09 |
CA2473512C CA2473512C (en) | 2013-02-05 |
Family
ID=33564674
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA2473512A Expired - Fee Related CA2473512C (en) | 2003-07-09 | 2004-07-09 | Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis |
Country Status (11)
Country | Link |
---|---|
US (1) | US7111769B2 (en) |
EP (1) | EP1508306B1 (en) |
JP (1) | JP4642395B2 (en) |
CN (1) | CN1636522A (en) |
AT (1) | ATE383822T1 (en) |
AU (2) | AU2004203119A1 (en) |
BR (1) | BRPI0402719B1 (en) |
CA (1) | CA2473512C (en) |
DE (1) | DE602004011298T2 (en) |
MX (1) | MXPA04006765A (en) |
PL (1) | PL1508306T3 (en) |
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-
2003
- 2003-07-09 US US10/615,973 patent/US7111769B2/en not_active Expired - Lifetime
-
2004
- 2004-07-08 DE DE602004011298T patent/DE602004011298T2/en active Active
- 2004-07-08 JP JP2004202145A patent/JP4642395B2/en active Active
- 2004-07-08 PL PL04254097T patent/PL1508306T3/en unknown
- 2004-07-08 AU AU2004203119A patent/AU2004203119A1/en not_active Abandoned
- 2004-07-08 AT AT04254097T patent/ATE383822T1/en not_active IP Right Cessation
- 2004-07-08 EP EP04254097A patent/EP1508306B1/en active Active
- 2004-07-09 CA CA2473512A patent/CA2473512C/en not_active Expired - Fee Related
- 2004-07-09 BR BRPI0402719-1A patent/BRPI0402719B1/en active IP Right Grant
- 2004-07-09 CN CNA2004100640837A patent/CN1636522A/en active Pending
- 2004-07-09 MX MXPA04006765A patent/MXPA04006765A/en active IP Right Grant
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2011
- 2011-02-28 AU AU2011200855A patent/AU2011200855B2/en not_active Ceased
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US10420548B2 (en) | 2007-09-21 | 2019-09-24 | Covidien Lp | Surgical device having multiple drivers |
US11317909B2 (en) | 2007-09-21 | 2022-05-03 | Covidien Lp | Surgical device having multiple drivers |
Also Published As
Publication number | Publication date |
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AU2004203119A1 (en) | 2005-01-27 |
US7111769B2 (en) | 2006-09-26 |
ATE383822T1 (en) | 2008-02-15 |
CA2473512C (en) | 2013-02-05 |
US20050006434A1 (en) | 2005-01-13 |
DE602004011298D1 (en) | 2008-03-06 |
JP4642395B2 (en) | 2011-03-02 |
DE602004011298T2 (en) | 2009-01-22 |
AU2011200855A1 (en) | 2011-03-17 |
EP1508306A1 (en) | 2005-02-23 |
AU2011200855B2 (en) | 2012-01-12 |
BRPI0402719B1 (en) | 2014-02-18 |
CN1636522A (en) | 2005-07-13 |
EP1508306B1 (en) | 2008-01-16 |
MXPA04006765A (en) | 2005-04-19 |
JP2005028146A (en) | 2005-02-03 |
PL1508306T3 (en) | 2008-07-31 |
BRPI0402719A (en) | 2005-06-14 |
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