Abstract:
An illuminated control surface is disclosed for use on a surgical instrument. The control surface may be disposed on a pushbutton switch located on a working head adapted for controlling the surgical tool. The light source may be an LED mounted remotely with respect to the illuminated control surface with light directed toward the control surface by a fiber optic strand. A translucent material may be selected for forming the control surface such that light may be directed through the material to illuminate the surface. Various colors and illumination patterns may be used to provide visual queues as to the status and operation of the instrument.

Description:
BACKGROUND 
       [0001]    1. Technical Field 
         [0002]    The present disclosure relates generally to surgical instruments and more specifically to surgical instruments having illuminated control surfaces and related methods. 
         [0003]    2. Background of Related Art 
         [0004]    A surgeon will often need to cut tissue, occlude vessels or perform some other procedure at an operative site on or within a patient. Instruments developed to facilitate these processes typically include a surgical tool on the distal end, appropriately configured to manipulate the targeted tissue, and a working head on the proximal end which the surgeon can use to control the position and operation of the tool. In some cases, a surgical instrument will additionally include a remote console coupled to the tool through wires, hoses or other flexible apparatus allowing for the free movement of the working head and tool. These remote consoles may provide fluids, electrical energy or other inputs to the tool and operative site. 
         [0005]    A conventional open surgical procedure involves a relatively large incision made in the body tissue in order to gain access the operative site. This practice exposes interior tissue to the open environment making it susceptible to infection and also requires a substantial portion of the body to heal after the surgery. An endoscopic or laparoscopic procedure, on the other hand, may reduce these difficulties by relying only on a small portal for access, which may be created by a puncture-like incision through the skin. A surgeon may insert an endoscope through the portal to view the operative site and determine how best to manipulate the other instruments. While it is not unusual for a surgeon to look directly into an endoscope through an ocular lens, it is more common for an endoscope to be associated with a camera system allowing the surgeon to view images on a video screen. In order to assist the surgeon in viewing these images, an endoscopic operating room may be darkened making it difficult to see the working head of an instrument. 
         [0006]    Endoscopic surgery is possible due in part to the availability of instruments designed specifically for this purpose. Such an instrument typically has an elongated body such that it may be positioned through a narrow cannula of the type often used in endoscopic surgery to hold the portal open. The tool at the distal end is positioned within the body at the operative site, while the working head at the proximal end remains in the open environment to be handled by a surgeon. Because the operating room may be darkened, and because much of the surgeon&#39;s attention is directed to images of the operative site, the working head is best designed for intuitive control of the tool. 
         [0007]    Some endoscopic instruments are designed to introduce electrical energy to an operative site in order to heat body tissue for various purposes. Electrosurgical forceps, for example, have been used to deliver a combination of electrical energy and mechanical clamping force to coagulate, cauterize and seal vessels. Generally, bipolar forceps grasp tissue between two poles disposed on pivotable jaws and apply an electrical current through the grasped tissue. A monopolar device, on the other hand, might deliver energy through a single pole where a remote return electrode is attached externally to the surgical subject. Bipolar energy is typically used for sealing vessels and vascular tissues while monopolar energy is typically used to coagulate or cauterize tissue. In either case, the current may be generated in a remote console and transmitted to the poles through a flexible cable. In some cases, a single procedure will require both types of energy (monopolar and bipolar), and some instruments have been adapted to selectively deliver both. An example of such an instrument is the endoscopic forceps described in U.S. patent application Ser. No. 11/540,335 by Patrick L. Dumbauld. 
         [0008]    Control mechanisms are provided to activate the various functions of a surgical tool. For example, opposed handles may be provided on the working head of a forceps assembly, which a surgeon may manually pivot to close the jaws. Additionally, switches may be disposed on either the working head or a remote console to allow a surgeon to initiate the flow of electricity, select the intensity of energy provided, and select the appropriate mode. Preferably these switches will be located on the working head so that the surgeon will not need to divert attention from the operative site to engage them. Other features of an instrument may also allow for a more intuitive use of the tool. 
       SUMMARY 
       [0009]    The present disclosure describes an instrument equipped with a surgical tool on a distal end and equipped with a working head on the proximal end. An illuminated control surface is disposed on the working head to facilitate manipulation of the tool. 
         [0010]    In a particular embodiment, the control surface is a pushbutton composed of a translucent material. Light from an LED light source in an interior cavity of the working head is directed through the button to illuminate the control surface. The color, intensity, or a pattern of illumination such as an intermittency (blinking) of the light emitted is adapted to provide information to a surgeon such as the location of the button in a darkened operating room, the function of the button, and an indication as to the appropriate use of the button. The light may be directed through a light pipe or fiber optic strand from a light source remotely located with respect to the button. Power for the light source may be provided by a battery within the instrument, or alternatively, power may be delivered by a remote console such as an electrosurgical generator. 
         [0011]    A method is also described for controlling a surgical tool. The method involves providing a surgical tool for manipulating tissue, a control surface to assist an operator in controlling the tool, and a light source adapted to illuminate the control surface. The operator may then identify a function associated with the control surface by the illumination of the control surface and manipulate the control surface to perform the function with the tool. The function may be to provide electrosurgical energy to the tool and such a function may be identified through illumination with a distinguishing color. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0012]    The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the present disclosure and, together with the detailed description of the embodiments given below, serve to explain the principles of the disclosure. 
           [0013]      FIG. 1  is a top perspective view of an illustrative embodiment of the disclosure including an endoscopic forceps assembly with two illuminated buttons; 
           [0014]      FIG. 2  is an enlarged perspective view of the internal components of the forceps of  FIG. 1  showing the two illuminated buttons, a circuit board, and a cable; 
           [0015]      FIG. 3  is top perspective view, with parts separated, of a control system for the forceps of  FIG. 1  showing an electrosurgical generator connected to the forceps by a flexible cable; and 
           [0016]      FIG. 4  is an enlarged partial side view of an illuminated button connected to the circuit board of  FIG. 3 . 
       
    
    
     DETAILED DESCRIPTION 
       [0017]    The present disclosure contemplates the introduction into a person&#39;s body of all types of surgical instruments including clip appliers, graspers, dissectors, retractors, staplers, laser fibers, photographic devices, endoscopes and laparoscopes, tubes, and the like. All such objects are referred to herein generally as “instruments.” In the drawings and in the description that follows, the term “proximal,” as is traditional, will refer to the direction toward the operator or a relative position on the surgical device or instrument that is closer to the operator, while the term “distal” will refer to the direction away from the operator or relative position of the instrument that is further from the operator. 
         [0018]    Referring initially to  FIG. 1 , a surgical instrument is depicted having two illuminated buttons  250 ,  260 . The instrument depicted is a relatively complex environment for use with the present disclosure and takes the form of an inline endoscopic combination monopolar and bipolar forceps assembly  1 , which may be used to electrosurgically treat tissue. Relevant components include end effector assembly  100 , shaft  12  having a distal end  16  and a proximal end  14 , working head  10  and cable  310 . Working head  10  includes housing  20 , intensity control  150 , two illuminated buttons  250  and  260  and handle assembly  30  which itself includes handles  30   a  and  30   b.    
         [0019]    End effector assembly  100  is configured to be positioned within body tissue to manipulate the tissue by clamping, electrosurgically energizing, cutting and/or otherwise contacting the tissue. At least one of the jaws  110 ,  120  on the end effector may be adapted to deliver electrosurgical energy in a monopolar fashion to the surrounding tissue, and both jaws  110 ,  120  in combination may be adapted to deliver electrosurgical energy in a bipolar fashion. The jaws  110 ,  120  are further adapted to move between an open position, as shown in  FIG. 1 , where the distal-most ends are substantially spaced and a closed position where they are closer together. 
         [0020]    Elongated shaft  12  couples end effector  100  to working head  10  and is narrow such that it may be inserted through a cannula for use in endoscopic procedures. Handle assembly  30  includes two moveable handles  30   a , and  30   b  disposed on opposite sides of housing  20 . Handles  30   a  and  30   b  are moveable relative to one another to activate end effector assembly  100  and move the jaws  110 ,  120  between their open and closed positions. Housing  20  is sized appropriately to allow handles  30   a ,  30   b  to be grasped and operated by a single hand. Cable  310  extends from the proximal end of housing  20  and serves to generally transfer information and energy between the forceps assembly  1  and a remote generator  500  (depicted in  FIG. 3 ). Intensity control  150  is coupled to cable  310  and end effector  100  such that the operator may select the intensity of energy delivered though the cable into the jaws of the end effector by sliding intensity control  150  in a proximal or distal direction. 
         [0021]    Finally, protruding through housing  20  are two illuminated buttons  250 ,  260 . Button  250 , when depressed, causes the delivery of energy to the end effector in a bipolar fashion, while depressing button  260  causes energy to be delivered in a monopolar fashion. Button  260  includes an array of raised protuberances on a top surface to provide a visual and tactile queue to distinguish it from button  250 . Alternatively, a single protrusion may suffice to distinguish the buttons  250 ,  260 . A visual queue may also be provided through the illumination of the buttons, as discussed below. 
         [0022]    Referring now to  FIG. 2 , working head  10  is depicted with a top portion of housing  20  removed to show the inner components. Lower housing  20   b  extends across the underside of the working head  10  and permits entry of cable  310 . Cable  310  is routed within working head  10  to overmold portion  315  where at least some of the individual conductors terminate and couple to circuit board  170 . Intensity control  150  and buttons  250 ,  260  are also coupled to circuit board  170  and, therefore, these controls are in electrical communication with cable  310 . Circuit board  170  is configured to receive inputs from the controls  150 ,  250 ,  260  and communicate electrical signals through cable  310  to generator  500  (shown in  FIG. 3 ) as to the type of electrosurgical energy to be delivered to end effector  100 . 
         [0023]      FIG. 3  depicts the control system of the forceps assembly  1  including electrosurgical generator  500 . Generator  500  is a remote source of both bipolar and monopolar electrosurgical energy coupled to cable  310  by leads  310   a ,  310   b . Generator  500  is envisioned as a stationary component that may remain in place as forceps assembly  1  is maneuvered into position and used to perform the desired procedure. Generator  500  may include controls such as a power switch or safety mechanisms to limit the power levels delivered. Because of its remote location, controls disposed on generator  500  are preferably limited to those used only at the initial setup or final stages of a surgical procedure. Controls frequently accessed during the procedure may be more conveniently located on the working head  10  so the surgeon will not need to divert attention from the procedure to access them. 
         [0024]    Cable  310  is shown wound into a bundle indicating that it may have a sufficient length to allow the surgeon some freedom of motion. At least some of the conductors of cable  310  lead into to the overmold portion  315  for connection with circuit board  170 . Other conductors may continue on to end effector  100 . Buttons  250 ,  260  are configured to seat within respective apertures  250 ′ and  260 ′ of upper housing  20   a  when assembled. Likewise, intensity control  150  is configured to slide within slot  150 ′ such that a portion of the intensity control  150  protrudes from upper housing  20   a  to modify the intensity of the electricity provided. The controls  150 ,  250 ,  260  are configured to effect changes in the circuitry found in circuit board  170 . Electrical signals are then communicated through cable  310  to generator  500 , which processes the signals to determine the appropriate type and level of energy to transmit to jaw members  110 ,  120 . 
         [0025]      FIG. 4  depicts a side cross sectional view of pushbutton  250  seated in aperture  250 ′ of upper housing  20   a . An upper control surface  251  protrudes to an exterior side of housing  20   a  and is adapted to be displaced by a finger. A button plunger  455  is disposed on the underside of button  250  and is adapted for activating a tactile switch  461  coupled to a control circuit on circuit board  170  when control surface  251  is displaced. The control circuit is adapted to cause the instrument to perform its desired function, in this case for example, to initiate or cease the delivery of bipolar energy to jaws  110 ,  120 . Light emitting diode (LED)  407  is disposed on circuit board  170  at a remote location relative to pushbutton  250 . Light pipe  444  provides an optical path for the transmission of light emitted from LED  407  to pushbutton  250 . Pushbutton  250  is formed at least partially from a translucent material, such that light entering from light pipe  444  will illuminate at least a portion of control surface  251 . 
         [0026]    Light pipe  444  may be any elongated transparent medium capable of transmitting light from LED  407  to pushbutton  250 . A mechanical connection of the light pipe  444  to either LED  407  or pushbutton  250  is not necessary as long as optical communication is established. Any suitable optical and/or mechanical connection may accommodate the motion of pushbutton  250 . A flexible fiber optic strand may be used as light pipe  444  and may be especially useful for transmitting light over relatively long distances, for example, from an LED light source on a remote circuit board not otherwise connected to the illuminated control. Suitable light sources other than LEDs may also be included. A traditional lamp mounted on a cable such that it is isolated from any circuit board may suffice. Power for the light source may be provided by a battery housed within the working head, or in a remote console, such as generator  500 . 
         [0027]    Also, it is contemplated that a control surface may be illuminated directly by a light source. For example, an LED may be positioned in the vicinity of a button such that at least a portion of the light emitted from the LED is directed directly through the control surface. In this way, a backlit button could be provided without the need for a light pipe. 
         [0028]    The illumination of button  250  may serve at least one of several suitable purposes. First, the illumination may assist a surgeon in locating the button, for example, in a darkened endoscopic operating room. In this case, the light source may be independent of any control circuitry coupled to button  250 . Button  250  may be adapted to remain constantly illuminated as long as LED  407  is powered, regardless of whether or not button  250  has been depressed. Secondly, the function of button  250  may be indicated through illumination. A distinguishing color, such as purple, may be used to indicate that button  250  activates the instrument&#39;s bipolar mode. This is especially useful when a similar button  260  is illuminated with a second distinguishing color, white for example, to indicate that button  260  activates the instrument&#39;s monopolar mode. 
         [0029]    Methods of achieving illumination of distinguishing colors are well known in the art. For example, LEDs are commercially available in a wide variety of colors which may be appropriate for use in the present application. Alternatively, illumination of distinguishing colors may be achieved, for example, by the application of paint or ink to an appropriate surface in the light path. An appropriate surface may include control surface  251 . Also, the color of the translucent material selected for button  250  may provide the color of the illumination. Thirdly, the illumination control surface  251  may be used to provide direction as to the use of button  250 . For example, LED  407  may be coupled through the control circuitry to contact switch  461  such that it emits light only when the contacts on switch  461  are closed. In this way, an illumination of control surface  251  could indicate to a surgeon that the bipolar mode of the instrument had been selected and was currently active. Additionally, the illumination of control surface  251  could provide a warning to the surgeon. For example, a warning may be provided to prevent accidental activation of a particular mode of the instrument. It may be dangerous to activate the bipolar mode of the instrument when the jaws  110 ,  120  are situated in the open, spaced apart position. Safety control circuitry adapted to recognize the status of jaws  110 ,  120  could be adapted to cause LED  407  to emit light intermittently when jaws  110 ,  120  are situated such that it is unsafe to depress button  250 . A flashing control surface might also direct the surgeon that the instrument has entered a lockout mode where depressing button  250  is ineffective. Alternatively, or in conjunction with a blinking button, a distinguishing color may be employed to indicate a condition satisfactory for depressing the button has been achieved. 
         [0030]    Control surfaces other than those on buttons  250 ,  260  may also be illuminated. For example, intensity control  150  is associated with makings on upper housing  20  representing numerals  1  through  5 . These markings are intended to provide a surgeon with a visual queue as to the effect of sliding intensity control  150  in one direction or the other. However, in a darkened operating room, these markings loose some of their effectiveness. A surgeon intending to lower the intensity of electricity delivered could easily slide intensity control  150  in the wrong direction and harm the patient. To help prevent this, the numerals themselves may be illuminated, or possibly a distinguishing color could be used at each end of aperture  150 ′ to provide a visual queue, for example, red at the distal end to represent higher intensity and blue at the proximal end to represent lower intensity. Such a visual queue might also be provided by varying the intensity of the light emitted from an aperture or surface. For example, the intensity of light emitted may be directly related to the intensity of the electrosurgical energy provided such that an increase in power delivered to the end effector  100  corresponds with an increase in LED power. Any knob, dial, handle, switch or other control mechanism, and any surfaces related to these control mechanisms, may be improved through illumination. 
         [0031]    Further, control surfaces mounted on a remote console may be improved through illumination. Due to their remote location, it may be difficult for a surgeon to ascertain current settings or other information available from the control surfaces from a distance. Illuminating these surfaces may eliminate the need for a surgeon to redirect an external light or walk to the console to assess the information. 
         [0032]    Although the foregoing disclosure has been described in some detail by way of illustration and example, for purposes of clarity or understanding, certain changes and modifications may be practiced within the scope of the appended claims.