Abstract:
A surgical instrument includes an elongate body, an elongate shaft, a collar, and an end effector. In particular, the elongate body defines a longitudinal axis, a lumen therethrough and an aperture in communication with the lumen. The elongate shaft is disposed at least partially within the lumen of the elongate body. The collar is mounted at least partially on the elongate shaft. The effector is detachably coupled with the elongate shaft. The elongate shaft is transitionable between a first position in which the elongate shaft is aligned with the longitudinal axis and a second position in which a portion of the elongate shaft having the collar mounted thereon transversely bends and protrudes through an aperture, thereby causing the end effector to move along the longitudinal axis with respect to the elongate body.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims the benefit of and priority to U.S. Provisional Patent Application No. 61/505,600, filed Jul. 8, 2011, the entire disclosure of which is incorporated by reference herein. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The present disclosure relates to a surgical instrument, and more particularly, to a surgical instrument having a flexible shaft transversely bendable to adjust longitudinal position of an end effector coupled thereto. 
         [0004]    2. Background of Related Art 
         [0005]    In laparoscopic and endoscopic surgical procedures, a small incision or puncture is made in a patient&#39;s body, e.g., in the abdomen, to provide an entry point for a surgical device. When compared to the larger incisions typically found in traditional procedures, both trauma to the patient and recovery time are reduced for procedures involving small incisions. Due to the relatively small interior dimensions of the access devices used in endoscopic procedures, only the elongated, small diametered instrumentation may be used to access the internal body cavities and organs. 
         [0006]    During such procedures, surgical objects, such as surgical access devices, e.g., trocar and cannula assemblies, are inserted into the patient&#39;s body through the incision in tissue. In general, prior to the introduction of the surgical object into the patient&#39;s body, insufflation gases are used to enlarge the area surrounding the target surgical site to create a larger, more accessible work area. 
         [0007]    The surgeon is then able to perform the procedure within the abdominal cavity by manipulating the instruments that have been extended through the access assemblies. The manipulation of such instruments within the internal body is similarly limited by both spatial constraints and the need to maintain the body cavity in an insufflated state. 
         [0008]    Accordingly, there is a need for a surgical instrument that enables the user to manipulate the position of the end effector within the internal body limited by spatial constraints. 
       SUMMARY 
       [0009]    In accordance with an embodiment of the present disclosure, there is provided a surgical instrument including an elongate body, an elongate shaft, a collar, an end effector. In particular, the elongate body defines a longitudinal axis, a lumen therethrough, and an aperture in communication with the lumen. The elongate shaft is disposed at least partially within the lumen of the elongate body. The collar is mounted at least partially on the elongate shaft. The end effector is detachably coupled with the elongate shaft, wherein the elongate shaft is transitionable between a first position in which the elongate shaft is aligned with the longitudinal axis and a second position in which a portion of the elongate shaft having the collar mounted thereon transversely bends and protrudes through the aperture, thereby causing the end effector to move along the longitudinal axis with respect to the elongate body. 
         [0010]    The elongate shaft may be a flexible member configured for transverse bending with respect to the longitudinal axis. The elongate body may define a plurality of circumferentially arranged apertures configured and dimensioned for passage therethrough of the portion of the elongate shaft having the collar mounted thereon. The elongate body may include an elastic sheath covering the aperture. The collar may be an O-ring. The collar may be disposed adjacent the aperture defined in the elongate body. The collar may have a smaller inner diameter than an outer diameter of the elongate shaft. The collar may be monolithically formed with the elongate shaft. 
         [0011]    In an embodiment, the surgical instrument may further include a ratchet assembly including a plurality of teeth on an inner wall of the elongate body and corresponding teeth on an outer surface of the elongate shaft. In particular, the plurality of teeth on the inner wall of the elongate body and the corresponding teeth on the outer surface of the elongate shaft may be configured for proximal movement of the elongate shaft with respect to the elongate body. The plurality of teeth on the inner wall of the elongate body may diametrically oppose each other. The plurality of teeth on the outer surface of the elongate shaft may also diametrically oppose each other. 
         [0012]    The elongate body may be rotatable with respect to the elongate shaft to engage the plurality of teeth disposed on the inner wall of the elongate body and the corresponding teeth on the outer surface of the elongate shaft. The plurality of teeth may be disposed adjacent a proximal end portion of the elongate body. 
         [0013]    The surgical instrument may further include a handle assembly including a rotatable member, wherein rotation of the rotatable member imparts rotation to the elongate body. 
         [0014]    In an embodiment, the end effector is a stapling device. Alternatively, the end effector may be a grasping assembly including a pair of jaws. The pair of jaws may be movable between an open position in which the jaws are spaced apart when the elongate shaft is in the first position and a closed position in which the jaws are disposed in a juxtaposed relation when the elongate shaft is in the second position. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0015]    Various embodiments of the present disclosure are described hereinbelow with reference to the drawings, wherein: 
           [0016]      FIG. 1  is a perspective view of a surgical instrument in accordance with an embodiment of the present disclosure; 
           [0017]      FIG. 2  is a top view of the surgical instrument of  FIG. 1 ; 
           [0018]      FIG. 3  is a side view of the surgical instrument of  FIG. 1 ; 
           [0019]      FIG. 4  is a partial perspective view of the distal region of the surgical instrument of  FIG. 1 ; 
           [0020]      FIG. 5  is a partial longitudinal cross-sectional view of the surgical instrument of  FIG. 4  illustrating a flexible elongate shaft in a neutral state; 
           [0021]      FIG. 6  is a partial longitudinal cross-sectional view of the surgical instrument of  FIG. 4  illustrating a portion of the flexible elongate shaft transversely bent; 
           [0022]      FIG. 7  is a cross-sectional view of an elongate body of the surgical instrument of  FIG. 1  illustrating a pair of opposing openings defined in the elongate body; 
           [0023]      FIG. 8  is a cross-sectional view of an elongate body for use with the surgical instrument of  FIG. 1  illustrating a plurality of openings circumferentially defined in the elongate body; 
           [0024]      FIG. 9  is a cross-sectional view of an elongate body for use with the surgical instrument of  FIG. 1  illustrating an elongate body openings having elastic covers; 
           [0025]      FIG. 10  is a cross-sectional view of an elongate body and a flexible shaft having a collar configured and dimensioned to facilitate passage through the openings; 
           [0026]      FIG. 11  is a cross-sectional view of an elongate body and a flexible shaft having a collar configured and dimensioned to facilitate passage through the openings defined in multiple directions; 
           [0027]      FIG. 12A  is a partial longitudinal cross-sectional view of a ratchet assembly for use with the surgical instrument of  FIG. 1  illustrating the ratchet assembly in a locked state; 
           [0028]      FIG. 12B  is a partial longitudinal cross-sectional view of the ratchet assembly of  FIG. 12A  in a disengaged state; 
           [0029]      FIG. 13  is a cross-sectional view of the ratchet assembly of  FIG. 12B  illustrating engaging mechanism; 
           [0030]      FIG. 14  is a perspective view of a surgical instrument in accordance with another embodiment of the present disclosure; 
           [0031]      FIG. 15  is a partial longitudinal cross-sectional view of the surgical instrument of  FIG. 14  illustrating a flexible shaft in a neutral state; and 
           [0032]      FIG. 16  is a partial longitudinal cross-sectional view of the surgical instrument of  FIG. 14  illustrating a portion of the flexible shaft transversely bent. 
       
    
    
     DETAILED DESCRIPTION OF EMBODIMENTS 
       [0033]    Embodiments of the present disclosure will now be described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “distal,” as is conventional, will refer to that portion of the instrument, apparatus, device or component thereof which is farther from the user while, the term “proximal,” will refer to that portion of the instrument, apparatus, device or component thereof which is closer to the user. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. 
         [0034]    With reference to  FIGS. 1-3 , there is illustrated an endoscopic surgical instrument  100  in accordance with an embodiment of the present disclosure. In the interest of brevity, this disclosure will focus primarily on the structures that enable longitudinal movement of an end effector  80 . A detailed discussion of the remaining components and method of use of surgical instrument  100  is disclosed in U.S. Pat. No. 6,953,139, the entire disclosure of which is incorporated herein by reference. 
         [0035]    Surgical instrument  100  includes a handle assembly  10 , an elongate body  50  extending from handle assembly  10  and an end effector  80 . Surgical instrument  100  defines a longitudinal axis “A-A.” Handle assembly  10  includes a stationary handle member  12 , a movable handle member  14 , and a barrel portion  16 . A rotatable member  18  is mounted on the distal end of barrel portion  16  to facilitate rotation of elongated body  50  with respect to handle assembly  10 . A pair of retraction knobs  13  is movably positioned along barrel portion  16  for manually repositioning an actuation shaft of stapling device  120  to a proximal direction. 
         [0036]    Elongate body  50  is configured for use in closed procedures, e.g., laparoscopic, endoscopic, and arthroscopic procedures. However, elongate body  50  may be shortened or removed for use in open procedures. End effector  80  is detachably coupled to handle assembly  10  via a flexible elongate shaft  70  extending through elongate body  50 . Flexible elongate shaft  70  is of a highly flexible and pliable nature and may include thin control wires (not shown) to manipulate flexible elongate shaft  70 , as will be discussed below. 
         [0037]    With reference now to  FIG. 4 , end effector  80  is a stapling device  120 . Endoscopic surgical instrument  100  may be configured and adapted for use with end effectors having alternative configurations such as, for example, clip applier, vessel sealing devices, circular stapling devices, dissectors, retractors, cutters, graspers. 
         [0038]    With reference now to  FIGS. 4-6 , stapling device  120  is releasably secured to a distal end portion of flexible elongate shaft  70 . In particular, stapling device  120  includes a cartridge assembly  82  housing a plurality of surgical staples and an anvil assembly  86  movably secured in relation to cartridge assembly  82 . Anvil assembly  86  is movable from an open position in which anvil assembly  86  is spaced apart from cartridge assembly  82  to a closed position in which anvil assembly  86  is substantially adjacent cartridge assembly  82 . In particular, cartridge assembly  82  defines rows of staple containing slots  84  and a knife slot  85  defined between rows of staple slots  84 . Stapling device  120  is configured to apply at least one row of staples. However, stapling device  120  may have various staple line lengths and configurations. Anvil assembly  86  includes a plurality of staple deforming concavities  88 . 
         [0039]    With continued reference to  FIGS. 4-6 , flexible elongate shaft  70  is disposed within elongate body  50 . Flexible elongate shaft  70  is coupled to handle assembly  10  and stapling device  120 . In particular, flexible elongate shaft  70  includes a collar  150  at least partially surrounding flexible elongate shaft  70 . Collar  150  is an O-ring. Collar  150  is made from an elastomer such as, e.g., polyurethane, polyethylene, silicone, and the like. Elongate body  50  defines a pair of opposing openings  54  configured and dimensioned to enable a portion of flexible elongate shaft  70  containing collar  150  to transversely bend and protrude through opening  54 . 
         [0040]    With continued reference to  FIGS. 5 and 6 , flexible elongate shaft  70  is transitionable between a neutral state in which flexible elongate shaft  70  is aligned with longitudinal axis “A-A” ( FIG. 5 ) and a deformed/transitioned state in which a portion of flexible elongate shaft  70  containing collar  150  is at least partially offset with respect to longitudinal axis “A-A” ( FIG. 6 ). Specifically, in the deformed/transitioned state, the portion of flexible elongate shaft  70  containing collar  150  at least partially protrudes through opening  54  defined in elongate body  50 . In this manner, by transitioning flexible elongate shaft  70  between the neutral state and the deformed/transitioned state, stapling device  120  may be moved along longitudinal axis “A-A” to a desired longitudinal position. 
         [0041]    With continued reference to  FIGS. 5 and 6 , flexible elongate shaft  70  is concentrically arranged within elongate body  50 . An actuation rod  11  is disposed within flexible shaft  70  and is operatively coupled with handle assembly  10  to actuate firing of staples. In the interest of brevity, and as not to obscure the present disclosure, the structural and functional features of actuation rod  11  will not be discussed herein. 
         [0042]    Collar  150  is mounted on flexible elongate shaft  70  adjacent openings defined in elongate body  50 . In particular, collar  150  has a smaller outer diameter than that of elongate body  50 , such that when flexible elongate shaft  70  is in the neutral state, collar  150  disposed around at least a portion of flexible elongate shaft  70  does not protrude through opening  54  defined in elongate body  50 . In addition, collar  150  has an inner diameter smaller than that of flexible elongate shaft  70  such that collar  150  applies compressive force against flexible elongate shaft  70  to facilitate bending of a portion of flexible elongate shaft  70  adjacent collar  150 . 
         [0043]    With particular reference now to  FIG. 6 , collar  150  and the portion of flexible elongate shaft  70  containing collar  150  are configured and dimensioned for passage through opening  54 . For example, a pair of control wires (not shown) may be utilized to effect bending of flexible elongate shaft  70  from a remote location, such as, for example, handle assembly  10 . In addition, it is contemplated that the bending mechanism may be electrically or gas powered. 
         [0044]    With reference to  FIGS. 1 and 7 , elongate body  50  of surgical instrument  100  defines a pair of diametrically opposing openings  54  to accommodate passage of collar  150  and the portion of flexible elongate shaft  70  containing collar  150  therethrough. However, it is also envisioned that an elongate body  250  may define a plurality of circumferentially defined openings  254  in multiple directions, as shown in  FIG. 8 . Such configuration enables transverse bending of flexible elongate shaft  70  in multiple directions. In this manner, by allowing bending of flexible elongate shaft  70  in multiple directions, manipulation of stapling device  120  along the longitudinal axis “A-A” is not limited by the orientation of bi-directional openings  54  defined in elongate body  50 , as shown in  FIG. 7 . 
         [0045]    With reference to  FIG. 9 , it is further contemplated that an opening  354  defined in an elongate body  350  may include a sheath/cover  90  having biocompatible and elastic features. Sheath  90  is affixed to elongate body  350  and covers openings  354 . The elastic characteristic of sheath  90  enables sheath  90  to expand and accommodate protrusion of flexible elongate shaft  70  and collar  150 . Under such configuration, the risk of body organs or tissue being trapped or pinched in opening  354  is minimized. 
         [0046]    With reference now to  FIG. 10 , it is also contemplated that a collar  430  may have a non-uniform annular cross-section. Specifically, collar  430  includes protruding portions that are configured and dimensioned for passage through opening  454  defined in elongate body  450 . In this manner, the size of opening  454  can be reduced to further reduce possible pinching or trapping of organs or tissue in opening  454 . In addition, the diameter of overall elongate body  450  may be reduced and/or the diameter of flexible elongate shaft  470  may be increased while retaining the same dimensions of elongate body  50 . The reduced diameter of elongate body  450  may be beneficial in a minimally invasive surgery by requiring a smaller opening or incision in the patient and the larger diameter of flexible elongate shaft  470  may provide the desired rigidity or the structural integrity of flexible elongate shaft  470 . In order to further facilitate transverse bending of flexible elongate shaft  570  in multiple directions, elongate body  550  may define a plurality of openings  554  in multiple directions, as shown in  FIG. 11 . 
         [0047]    With reference now to  FIGS. 12A and 12B , it is further envisioned that surgical instrument  100  may include a ratchet assembly. An elongate body  650  includes a plurality of teeth  655 A,  655 B on an inner wall  651  thereof. In addition, flexible elongate shaft  670  disposed within elongate body  650  also includes a plurality of corresponding teeth  675 A,  675 B on an outer surface  672  thereof. Teeth  655 A,  655 B disposed on inner wall  651  of elongate body  650  engage teeth  675 A,  675 B disposed on outer surface  672  of elongate shaft  670 . In particular, the plurality of teeth  655 A,  655 B,  675 A,  675 B are such that that flexible elongate shaft  670  is movable in a single direction relative to elongate body  650  when teeth  655 A,  655 B,  675 A,  675 B are engaged ( FIG. 12A ). In particular, teeth  655 A,  655 B,  675 A,  675 B are configured to enable proximal movement of flexible elongate shaft  670  relative to elongate body  650 , but teeth  655 A,  655 B,  675 A,  675 B inhibit relative distal movement of flexible elongate shaft  670 . 
         [0048]    With reference to  FIG. 13 , teeth  655 A,  655 B disposed on inner wall  651  of elongate body  650  diametrically oppose each other. Similarly, teeth  675 A,  675 B on outer surface  672  of flexible elongate shaft  670  also diametrically oppose each other. In this manner, flexible elongate shaft  670  locked in a deformed/transition state by teeth  655 A,  655 B,  675 A,  675 B may be released from the locked state by rotating rotatable member  18  on handle assembly  10  which imparts rotation to elongate body  650 . Specifically, rotation of elongate body  650  in either direction “X,” “Y” disengages teeth  655 A,  655 B,  675 A,  675 B. It is envisioned that in order to minimized interference with transverse bending of flexible elongate shaft  670  through opening defined in elongate body  670 , teeth  655 A,  655 B,  675 A,  675 B are disposed proximal of the openings, for example, adjacent handle assembly  10 . 
         [0049]    In use, an incision is made through the abdominal wall of a patient and an access cannula (not shown) is inserted therethrough. The access cannula is connected to a source of insufflation fluid for creating an operative space within a body cavity. Surgical instrument  100  is inserted through the access cannula and into the surgical site within the body cavity. Through the use of, for example, the control wires, flexible elongate shaft  70  may be longitudinally moved to position end effector  80  in a desired surgical site. Thereafter, the surgeon may perform the desired surgical procedure. In the case of surgical instrument  100 , the surgeon may actuate the handle assembly  10  to effect surgical stapling of tissue. 
         [0050]    In accordance with another embodiment of the present disclosure, a surgical grasping instrument  1000  is illustrated in  FIGS. 14-16 . Grasping instrument  1000  includes a handle assembly  1010 , a grasping assembly  1080  and an elongate member  1050  extending distally from handle assembly  1010  and terminating in grasping assembly  1080 . Handle assembly  1010  includes a stationary handle member  1012  and a movable handle member  1014 . Squeezing movable handle member  1014  toward stationary handle member  1012  actuates grasping assembly  1080 . 
         [0051]    Elongate body  1050  is configured for use in closed procedures, e.g., laparoscopic, endoscopic, and arthroscopic procedures. However, elongate body  1050  may be shortened or removed for use in open procedures. Grasping assembly  1080  is detachably coupled to handle assembly  1010  via a flexible elongate shaft  1070  extending through elongate body  1050 . Flexible elongate shaft  1070  is of a highly flexible and pliable nature to enable transverse bending with respect to the longitudinal axis defined by longitudinal axis “B-B” ( FIG. 15 ). 
         [0052]    With continued reference now to  FIGS. 15 and 16 , grasping assembly  1080  is releasably secured to a distal end portion of flexible elongate shaft  1070 . In particular, grasping assembly  1080  includes a pair of jaws  1084 ,  1086 . The pair of jaws  1084 ,  1086  is movable between an open position in which jaws  1084 ,  1086  are spaced apart and a closed position in which jaws  1084 ,  1086  are disposed in a juxtaposed relation to clamp, e.g., tissue or other surgical instruments, therebetween. 
         [0053]    Flexible elongate shaft  1070  is disposed within elongate body  1050 . Flexible elongate shaft  1070  is coupled to handle assembly  1010  and grasping assembly  1080 . In particular, flexible elongate shaft  1070  includes a collar  1150  at least partially surrounding flexible elongate shaft  1070 . Collar  1150  is an O-ring. Elongate body  1050  defines a pair of diametrically opposing openings  1054  configured and dimensioned to enable a portion of flexible elongate shaft  1070  containing collar  1150  to protrude through opening  1054 . 
         [0054]    With continued reference to  FIGS. 15 and 16 , flexible elongate shaft  1070  is transitionable between a neutral state in which flexible elongate shaft  1070  is aligned with longitudinal axis “B-B” and a deformed/transitioned state in which a portion of flexible elongate shaft  1070  containing collar  1150  is at least partially offset with respect to longitudinal axis “B-B.” Specifically, in the deformed/transitioned state, collar  1150  along with the portion of flexible elongate shaft  1070  containing collar  1150  at least partially protrudes through opening  1054  defined in elongate body  1050 . In this manner, by transitioning flexible elongate shaft  1070  between the neutral state and the deformed/transitioned state, grasping assembly  1080  may be moved along longitudinal axis “B-B” to a desired longitudinal position. 
         [0055]    Flexible elongate shaft  1070  is concentrically arranged within elongate body  1050 . Flexible shaft  1070  is operatively coupled with handle assembly  1010 . Collar  1150  is mounted on flexible elongate shaft  1070  adjacent opening  1054  defined in elongate body  1050 . In particular, collar  1150  has a smaller outer diameter than that of elongate body  1050 , such that when flexible elongate shaft  1070  is in the neutral state, collar  1150  mounted on flexible elongate shaft  1070  remains within elongate body  1050 . In addition, collar  1150  has an inner diameter smaller than that of flexible elongate shaft  1070  such that collar  1150  applies compressive force against flexible elongate shaft  1070  to facilitate transverse bending of a portion of flexible elongate shaft  1070  adjacent collar  1150 . 
         [0056]    With particular reference now to  FIG. 16 , in the deformed/transitioned state, collar  1150  and the portion of flexible elongate shaft  1070  containing collar  1150  protrude through opening  1054 . For example, a pair of control wires (not shown) may be utilized to effect transverse bending of flexible elongate shaft  1070 , whereby squeezing of movable handle member  1014  toward stationary handle member  1012  moves grasping assembly  1080  in a proximal direction and collar  1150  protrudes at least partially through opening  1054 . 
         [0057]    When handle assembly  1010  is actuated, grasping assembly  1080  is moved proximally and collar  1150  at least partially protrudes out of one of the pair of diametrically opposing openings  1054 . Specifically, as grasping assembly  1080  moves proximally the pair of jaws  1084 ,  1086  is at least partially received within elongate body  1050 , whereby grasping assembly  1080  is transitioned into the closed state. 
         [0058]    It is further contemplated that grasping instrument  1000  may include a ratchet mechanism to enable relative movement of grasping assembly  1080  in a single direction, such as proximal direction and inhibit movement in the distal direction. Under such configuration, tissue or a surgical instrument clamped between jaws  1084 ,  1086  may remain clamped therebetween during the surgical procedure. As discussed hereinabove, it is also envisioned that elongate body  1050  may define a plurality of openings to enable transverse bending of flexible elongate shaft  1070  in multiple directions. In addition, collar  1150  may have a non-uniform annular cross- section to facilitate passage through openings  1054  defined in elongate body  1050 . Furthermore, opening  1054  defined in elongate body  1050  may include a sheath affixed thereto to inhibit, e.g., pinching or trapping of tissue, within opening  1054 . 
         [0059]    Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure, and figures should not be construed as limiting, but merely as exemplifications of particular embodiments. It is to be understood, therefore, that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure.