SURGICAL INSTRUMENTS HAVING A ROTATABLE BLADE MEMBER FOR TREATING TISSUE

A surgical instrument for treating tissue includes an articulating elongated shaft (14), a drive shaft (28) extending through the elongated shaft and configured to rotate about a longitudinal axis defined by the drive shaft, and an end effector assembly (100) coupled to a distal end portion of the elongated shaft. The end effector assembly includes a jaw member (110) and a blade member (112) configured to rotate in response to a rotation of the drive shaft to treat tissue disposed between the jaw member and the blade member.

FIELD

The present technology is generally related to surgical instruments and, more particularly, to tissue treating mechanisms for use with surgical end effector assemblies, instruments, and systems.

BACKGROUND

A surgical forceps is a pliers-like instrument that relies on mechanical action between jaw members of its end effector assembly to grasp, clamp, and constrict tissue. Some surgical forceps utilize both mechanical clamping action and energy to accurately sever the tissue. Accordingly, many surgical forceps incorporate a knife, an ultrasonic blade, or other suitable cutting members utilized to effectively treat the tissue clamped by the end effector assembly.

During laparoscopic or endoscopic surgical procedures, access to a surgical site is achieved through a small incision or through a narrow cannula inserted through a small entrance wound in a patient. Because of limited area available to access the surgical site, many surgical forceps include mechanisms for articulating the end effector assembly thereof in relation to a body portion of the forceps to improve access to tissue to be treated.

SUMMARY

The techniques of this disclosure generally relate to surgical instruments for sealing and/or cutting tissue. In accordance with aspects of the disclosure, the surgical instrument includes an elongated shaft, a drive shaft extending through the elongated shaft, and an end effector assembly coupled to a distal end portion of the elongated shaft. The distal end portion of the elongated shaft is configured to articulate relative to a proximal end portion of the elongated shaft, and the drive shaft is configured to rotate about a longitudinal axis defined by the drive shaft. The drive shaft has a proximal end portion configured to be operably coupled to a drive motor. The end effector assembly includes a jaw member pivotable relative to the distal end portion of the elongated shaft, and a blade member opposing the jaw member. The blade member is non-rotationally supported on a distal end portion of the drive shaft, such that the blade member is configured to rotate in response to a rotation of the drive shaft to treat tissue disposed between the jaw member and the blade member via friction created by the rotational motion of the drive shaft.

In aspects, the blade member may have a cylindrical configuration.

In aspects, the drive shaft may be flexible along a length thereof, such that the drive shaft flexes as the distal end portion of the elongated shaft articulates.

In aspects, the distal end portion of the elongated shaft may be configured to articulate from a first position, in which the end effector assembly is parallel with a longitudinal axis defined by the elongated shaft, and at least one second position, in which the end effector assembly is offset from the longitudinal axis defined by the elongated shaft.

In aspects, the drive shaft may have an intermediate portion interconnecting the proximal and distal end portions of the drive shaft. The proximal and distal end portions of the drive shaft may be rigid and the intermediate portion being flexible.

In aspects, the distal end portion of the elongated shaft may have an articulating section. The intermediate portion of the drive shaft may be disposed within the articulating section.

In aspects, the distal end portion of the elongated shaft may have a rigid distal section extending distally from the articulating section. The proximal end portion of the elongated shaft may be rigid and extend proximally from the articulating section.

In aspects, the proximal end portion of the drive shaft may be received in the proximal end portion of the elongated shaft. The distal end portion of the drive shaft may be received in the rigid distal section.

In aspects, the drive shaft may have a universal joint interconnecting the proximal and distal end portions of the drive shaft.

In aspects, the proximal and distal end portions of the drive shaft may each be rigid along their length.

In aspects, the surgical instrument may further include a clutch mechanism detachably coupling the proximal end portion of the drive shaft and the drive motor.

In accordance with another aspect of the disclosure, a hand-held surgical instrument is provided and includes a handle assembly, an elongated shaft, a drive shaft, and an end effector assembly. The handle assembly has a handle housing, a drive motor disposed within the handle housing, an articulation switch movably coupled to the handle housing, and a trigger movably coupled to the handle housing. The elongated shaft has a proximal end portion coupled to the handle housing, and a distal end portion configured to articulate relative to the proximal end portion in response to an actuation of the articulation switch. The drive shaft extends longitudinally along the elongated shaft and is configured to rotate about a longitudinal axis defined by the drive shaft. The drive shaft has a proximal end portion operably coupled to the drive motor. The end effector assembly is coupled to the distal end portion of the elongated shaft and includes a jaw member and a blade member opposing the jaw member. The jaw member is pivotable relative to the distal end portion of the elongated shaft. The blade member is coupled to a distal end portion of the drive shaft, such that the blade member is configured to rotate in response to an actuation of the trigger to treat tissue disposed between the jaw member and the blade member.

In accordance with yet another aspect of the disclosure, a surgical instrument for treating tissue is provided and includes an elongated shaft, a tubular shaft extending through the elongated shaft, and a blade member coupled to a distal end portion of the tubular shaft. The tubular shaft defines a lumen configured to receive a fluid, and the blade member defines an internal chamber in fluid communication with the lumen. The blade member has a plurality of vanes, such that the blade member is configured to rotate relative to the tubular shaft in response to the fluid moving over the plurality of vanes.

In aspects, the elongated shaft may have a proximal end portion, and a distal end portion configured to articulate relative to the proximal end portion.

In aspects, the tubular shaft may be flexible along a length thereof, such that the drive shaft flexes as the distal end portion of the elongated shaft articulates.

In aspects, the surgical instrument may further include a jaw member pivotable relative to the distal end portion of the elongated shaft and configured to clamp tissue between the jaw member and the blade member.

As used herein, the term “distal” refers to the portion that is being described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. Further, to the extent consistent, any or all of the aspects detailed herein may be used in conjunction with any or all of the other aspects detailed herein.

DETAILED DESCRIPTION

The disclosure is generally directed to a minimally invasive surgical instrument for grasping and treating tissue using a rotating blade member. Some surgical instruments have a blade member in communication with an ultrasonic transducer for vibrating the blade member at ultrasonic frequencies suitable for treating (e.g., cutting and/or sealing) tissue contacted by the blade member. To transfer ultrasonic energy to the blade member, a rigid waveguide typically interconnects the ultrasonic transducer and the blade member. Due to the rigid nature of most waveguides, it is difficult to incorporate an articulating function into ultrasonic surgical instruments. The surgical instrument of the disclosure cures these and other drawbacks of ultrasonic surgical instruments.

The surgical instrument of the disclosure may be hand-held or have components configured to be operated by a robotic system. The surgical instrument includes an elongated shaft having an end effector assembly coupled to a distal end portion thereof. The elongated shaft has a flexible or bendable articulating section that allows the distal end portion and the attached end effector assembly to articulate in a plurality of directions. The end effector assembly has a pivotable jaw member and a rotatable blade member in opposing relation with the jaw member. Tissue may be grasped between the jaw member and the blade member, whereby the blade member is rotated to treat the grasped tissue due to the friction generated between the rotating blade member and the grasped tissue. The blade member is driven by a rotatable drive shaft extending through the elongated shaft. The drive shaft has a flexible, pivotable, or bendable portion that articulates with an articulation of the elongated shaft while also allowing for the transfer of rotational forces through the elongated shaft and to the blade member.

Referring generally toFIGS.1A and1B, an endoscopic, hand-held surgical instrument10includes a handle assembly12, an endoscopic portion, such as, for example, an elongated shaft14extending distally from the handle assembly12, and an end effector assembly100coupled to a distal end portion14bof the elongated shaft14. The handle assembly12includes a handle housing16having a fixed handle18integrally associated therewith, and a movable handle20movable relative to the fixed handle18. The movable handle20is operably coupled to a drive assembly (not shown) configured to impart movement of a jaw member110of the end effector assembly100about a pivot103relative to a blade member112of the end effector assembly100.

The jaw member110is configured to move between a spaced-apart position (FIG.1A) and an approximated position (FIG.1B) to grasp tissue between the jaw member110and the blade member120. As shown inFIG.1A, the movable handle20is disposed in a spaced-apart position relative to the fixed handle18and, correspondingly, the end effector assembly100is disposed in the spaced-apart position. The movable handle20is depressible from the spaced-apart position to a depressed position corresponding to the approximated position of the end effector assembly100(FIG.1B). In aspects, the surgical instrument10may be devoid of the jaw member110.

The handle assembly12further includes a plurality of articulation actuators24and a trigger26each movably coupled to the handle housing16. The articulation actuators24are configured to effectuate an articulation of the end effector assembly100between a non-articulated position (FIG.1A), in which the end effector assembly100is coaxial or otherwise parallel with the longitudinal axis “X” defined by the elongated shaft14, and at least one articulated position (FIG.1B), in which the end effector assembly100is offset from the longitudinal axis “X” defined by the elongated shaft14. The trigger26is pivotable relative to the handle housing16and is configured to actuate a drive motor122(FIG.2) to drive a rotation of the blade member112of the end effector assembly100. In aspects, the drive motor122may be configured to increase the rotational speed of the blade member112as the trigger26approximates the fully-actuated position. In aspects, detents may be provided on the trigger26to provide a user with tactile feedback to indicate the rotational speed of the blade member112. As an alternative to a pivoting trigger26, a slide trigger, push-button, toggle switch, or other suitable actuator may be provided. The surgical instrument10may be powered via an internal battery (not explicitly shown) or, alternately, by an external power source via a cable28or a cable-free connection to a robot arm.

The proximal end portion14aof the elongated shaft14is non-rotationally coupled to a rotatable knob housing30, which is rotatably coupled to the handle housing16, such that the elongated shaft14and the attached end effector assembly100are configured to rotate about a longitudinal axis “X” defined by the elongated shaft14. The proximal end portion14aof the elongated shaft14may be rigid along its length to maintain a linear configuration during use. The distal end portion14bof the shaft14has a rigid distal section32connected to the end effector assembly100and an articulating section34disposed between the rigid distal section32and the proximal end portion14a. The articulating section34includes a plurality of articulating links36having a plurality of articulation cables38extending therethrough. Each cable38is operably engaged at its distal end to the rigid distal section32and at its proximal end to one of the articulation actuators24so as to enable articulation of the rigid distal section32and, thus, the end effector assembly100, relative to the proximal end portion14aupon actuation of one or more of the articulation actuators24. In some aspects, the articulating section34and the articulation actuators24may be omitted, such that the elongated shaft14does not articulate.

With reference toFIG.2, the surgical instrument10includes a drive assembly120for driving a rotation of the blade member112of the end effector assembly100. The drive assembly120includes a drive motor122received in the handle housing16(FIG.1A) or in a robot arm1002(FIG.6) and a drive shaft124extending through the elongated shaft14(FIG.1A). The blade member112is integrally formed with or otherwise attached to a distal end portion124bof the drive shaft124and is non-rotatable relative to the drive shaft124. The blade member112may have a cylindrical configuration and be fabricated from a metal having a coarse outer surface (e.g., knurls, splines, abrasive material having a grit size from about20to about1500, etc.) to increase the frictional engagement between the blade member112and tissue. In aspects, the blade member112may assume any suitable shape, such as, for example, a rectangle, a triangle, a sphere, or the like, and may be fabricated from any suitable material, such as, for example, plastics, metals, etc. The blade member112may have a smooth outer surface or surface projections, such as, for example, a plurality of spikes extending from the outer surface thereof. In aspects, spikes or other suitable surface features on the blade member112may be formed via any suitable process, such as chemically etching.

The drive motor122may be an electric motor operably coupled to a proximal end portion124aof the drive shaft124. The drive motor122drives a rotation of the drive shaft124about a longitudinal axis of the drive shaft124. The proximal end portion124aof the drive shaft124may be directly, operably coupled to the drive motor122or indirectly, operably coupled to the drive motor122via a series of gears, belts, screws, linkages, or the like. The drive shaft124is fabricated from a flexible material, such as, for example, rubber, plastics, metals, etc., to allow the drive shaft124to flex or otherwise bend during articulation of the articulating section34(FIG.1B) of the elongated shaft14while also maintaining the ability to transfer rotational forces from the drive motor122to the blade member112. In aspects, the drive shaft124may be a tube, a non-cannulated shaft, or include a bundle of metal wires.

In operation, tissue is positioned between the jaw member110and the blade member112with the end effector assembly100in the spaced-apart position, as shown inFIG.1A. To treat or otherwise seal/cut the tissue during a surgical procedure, the movable handle20is actuated toward the depressed position (FIG.1B), whereby the jaw member110is pivoted toward the blade member112to close the end effector assembly100about the tissue. With the end effector assembly100in the closed position, as shown inFIG.1B, the trigger26may be actuated to activate the drive motor122of the drive assembly120. The drive motor122drives a rotation of the drive shaft124, in the direction indicated by arrow “A” inFIG.2, thereby inducing a corresponding rotation of the blade member112. The rotational speed of the blade member112may be sufficient to treat the tissue due to the high friction between the blade member112and the tissue. In aspects, the high friction between the blade member112and the tissue may be sufficient only to cut the tissue and RF energy or another suitable type of energy may be applied to the tissue to seal the tissue. In aspects, the rotational speed of the blade member112may be from about 1,000 revolutions per minute (“RPM”) to about 350,000 RPM, and in some aspects, from about 20,000 RPM to about 40,000 RPM. In some aspects, the surgical instrument10may cut through tissue without having to clamp the tissue between the jaw member110and the blade member112. In aspects, the distal-facing tip or edge of the blade member112may be oriented perpendicular to the tissue surface and rotated to form an opening or hole in the tissue. It is contemplated that the distal-facing edge of the blade member112may have a coarse outer surface to enhance the frictional engagement between the distal-facing edge and the tissue surface.

FIG.3illustrates another embodiment of a drive assembly220for use in the surgical instrument10ofFIGS.1A and1Binstead of the drive assembly120ofFIG.2. The drive assembly220includes an electric drive motor222and an elongated drive shaft224operably coupled to the drive motor222. The blade member112is integrally connected to or otherwise attached to a distal end portion224bof the drive shaft224. The drive shaft224ofFIG.3differs from the drive shaft124ofFIG.2by being made up of three discrete longitudinal segments, namely a proximal end portion224a, a distal end portion224b, and an intermediate portion224cinterconnecting the proximal and distal end portions224a,224b.

The proximal and distal end portions224a,224bare both rigid along their lengths (e.g., the proximal and distal end portions224a,224bare configured to resist twisting and bending), whereas the intermediate portion224cis flexible along its length to allow for flexing of the intermediate portion224cduring articulation of the articulating section34(FIG.1B). In particular, upon assembly of the drive shaft224into the elongated shaft14(FIG.1B), the proximal end portion224aof the drive shaft224extends through the rigid proximal end portion14aof the elongated shaft14, the intermediate portion224cof the drive shaft224extends through the articulating section34of the elongated shaft14, and the distal end portion224bof the drive shaft224extends through the rigid distal section32of the distal end portion14bof the elongated shaft14.

FIG.4illustrates another drive assembly320suitable for use in the surgical instrument10ofFIGS.1A and1Binstead of the drive assembly120ofFIG.2. The drive assembly320includes an electric drive motor322and an elongated drive shaft324operably coupled to the drive motor322via a clutch mechanism326. The blade member112is integrally connected to or otherwise attached to a distal end portion324bof the drive shaft324. The clutch mechanism326detachably couples the proximal end portion324aof the drive shaft324to the drive motor322. The clutch mechanism326may include a first plate328attached to a drive rod330, which is rotationally driven by the drive motor322, and a second plate332fixed to the proximal end portion324aof the drive shaft324. The first and second plates328,332may each have opposing, high friction surfaces that when engaged with one another allow for the transfer of rotational forces therebetween.

The drive rod330may be axially movable relative to the drive motor322to selectively engage and disengage the first and second plates328,332. In other aspects, the drive shaft324may be axially movable to selectively engage and disengage the first and second plates328,332. It is contemplated that the clutch mechanism326may have various configurations, such as a centrifugal clutch, a hydraulic clutch, an electromagnetic clutch, a diaphragm clutch, etc. In aspects, the clutch mechanism326may be incorporated into any of the drive shafts described herein.

The drive shaft324may further include a universal joint334that interconnects the proximal and distal end portions324a,324bof the drive shaft324. The universal joint334is received in the articulating section34(FIG.1B) of the elongated shaft14to allow the distal end portion324bof the drive shaft324to articulate with the distal end portion14bof the elongated shaft14. The proximal and distal end portions324a,324bof the drive shaft324may each be rigid along their lengths to resist twisting or bending of the proximal and distal end portions324a,324bof the drive shaft324during rotation of the drive shaft324.

In operation of the drive assembly320, prior to treating tissue and upon powering on the surgical instrument10, the drive motor322may be automatically activated to rotate the drive rod330and the attached first plate328of the clutch mechanism326at a predetermined rate while the drive shaft324is disengaged from the drive motor322. To treat or otherwise cut tissue, the clutch mechanism326is engaged by actuating the trigger26, whereby the first and second plates328,332are non-rotationally engaged. With the drive shaft324non-rotationally coupled to the drive rod330, the rotational motion of the drive rod330is transferred to the blade member112via the drive shaft324. In this way, when the treating function of the blade member112is desired, the drive shaft324and the attached blade member112may assume a rotational speed at a suitable rpm instantaneously upon engaging the already-rotating first plate328with the second plate332of the drive shaft324.

FIG.5illustrates another assembly420suitable for use in the surgical instrument10ofFIGS.1A and1Binstead of the drive assembly120ofFIG.2. The drive assembly420may be configured similarly to a pneumatic turbine and includes a source of pressurized fluid422(e.g., a canister of compressed CO2), a tubular shaft424, such as, for example, a hose extending through the elongated shaft14(FIG.1A), and a blade member412. The tubular shaft424is flexible along its length to allow for articulation of the elongated shaft14and defines a lumen426therethrough in communication with the source of pressurized fluid422. In aspects, the trigger26(FIG.1A) of the handle assembly12may be operably coupled to a valve (not explicitly shown) of the source of pressurized fluid422to selectively release a compressed fluid from the source of pressurized fluid422into the lumen426of the tubular shaft424. In aspects, the valve may be located remotely, such as in a robot arm (e.g., robot arm1002ofFIG.6).

The blade member412is rotatably coupled to a distal end portion428of the tubular shaft424. The blade member412has a proximal body portion414and an elongated tissue-treating segment or shaft416extending from the proximal body portion414. The proximal body portion414defines an internal chamber430in fluid communication with the lumen426of the tubular shaft424. The proximal body portion414of the blade member412also defines a plurality of vanes417(e.g., fins or blades) circumferentially disposed about the blade member412and in fluid communication with the lumen426of the tubular shaft424. The vanes417are arranged and structured such that the blade member412rotates about a longitudinal axis defined by the rigid distal section32(FIG.1B) as fluid passes from within the lumen426and out of the blade member412via the vanes417.

Referring generally toFIG.6, a robotic surgical system exemplifying the aspects and features of the present disclosure is shown generally identified by reference numeral1000. For the purposes herein, robotic surgical system1000is generally described. Aspects and features of robotic surgical system1000not germane to the understanding of the present disclosure are omitted to avoid obscuring the aspects and features of the present disclosure in unnecessary detail.

Robotic surgical system1000includes a plurality of robot arms1002,1003; a control device1004; and an operating console1005coupled with control device1004. Operating console1005may include a display device1006, which may be set up in particular to display three-dimensional images; and manual input devices1007,1008, by means of which a surgeon may be able to telemanipulate robot arms1002,1003in a first operating mode. Robotic surgical system1000may be configured for use on a patient1013lying on a patient table1012to be treated in a minimally invasive manner. Robotic surgical system1000may further include a database1014, in particular coupled to control device1004, in which are stored, for example, pre-operative data from patient1013and/or anatomical atlases.

Each of the robot arms1002,1003may include a plurality of members, which are connected through joints, and an attaching device1009,1011, to which may be attached, for example, an end effector assembly1100,1200, respectively. End effector assembly1100is similar to the end effector assembly100(FIGS.1A and1B), although other suitable end effector assemblies for coupling to attaching device1009are also contemplated. End effector assembly1200may be any end effector assembly, e.g., an endoscopic camera, other surgical tool, etc. Robot arms1002,1003and end effector assemblies1100,1200may be driven by electric drives, e.g., motors, that are connected to control device1004. Control device1004(e.g., a computer) may be configured to activate the motors, in particular by means of a computer program, in such a way that robot arms1002,1003, their attaching devices1009,1011, and end effector assemblies1100,1200execute a desired movement and/or function according to a corresponding input from manual input devices1007,1008, respectively. Control device1004may also be configured in such a way that it regulates the movement of robot arms1002,1003and/or of the motors.