MULTI-FUNCTION SURGICAL INSTRUMENTS

A surgical instrument includes an end effector assembly having first and second jaw members at least one of which is movable relative to the other between a spaced-apart position and an approximated position for grasping tissue therebetween. A sheath is movable relative to the end effector assembly between a retracted position, wherein the sheath is positioned proximally of the first and second jaw members, and an extended position, wherein the sheath is disposed about the first and second jaw members. The sheath is configured to fluidly couple to a source of at least one of suction or irrigation to provide at least one of suction or irrigation at a surgical site.

FIELD

The present disclosure relates to surgical instruments and, more specifically, to multi-function surgical instruments.

BACKGROUND

In minimally-invasive surgical procedures, operations are carried out within an internal body cavity through small entrance openings in the body. The entrance openings may be natural passageways of the body or may be surgically created, for example, by making a small incision into which a cannula is inserted.

Multi-function surgical instruments are beneficial in that they allow multiple surgical tasks to be performed with a single instrument, obviating the need to alternatingly remove and insert different instruments into the surgical site to perform a surgical task and/or obviating the need for simultaneously inserting multiple instruments into the surgical site to perform a surgical task.

SUMMARY

As used herein, the term “distal” refers to the portion that is 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, any or all of the aspects described herein, to the extent consistent, may be used in conjunction with any or all of the other aspects described herein.

Provided in accordance with aspects of the present disclosure is a surgical instrument including an end effector assembly including first and second jaw members. At least one of the first or second jaw members is movable relative to the other between a spaced-apart position and an approximated position for grasping tissue therebetween. A sheath is movable relative to the end effector assembly between a retracted position, wherein the sheath is positioned proximally of the first and second jaw members, and an extended position, wherein the sheath is disposed about the first and second jaw members. The sheath is configured to fluidly couple to a source of at least one of suction or irrigation to provide at least one of suction or irrigation at a surgical site.

In an aspect of the present disclosure, the surgical instrument further includes a housing and a shaft extending distally from the housing. In such aspects, the end effector assembly is supported at a distal end of the shaft and the sheath is slidably disposed about the shaft.

In another aspect of the present disclosure, a fluid port is disposed on the housing and configured to connect to the source of suction and/or irrigation. In such aspects, an internal fluid line disposed within the housing fluidly couples the sheath with the fluid port.

In still another aspect of the present disclosure, at least one actuator disposed on the housing is selectively actuatable for deploying and retracting the sheath.

In yet another aspect of the present disclosure, a movable handle extends from the housing and couples to the at least one of the first or second jaw members. The movable handle is selectively actuatable to move the at least one of the first or second jaw members relative to the other.

In still yet another aspect of the present disclosure, the sheath defines an open distal end and is configured to provide the at least one of suction or irrigation through the open distal end thereof. Alternatively or additionally, the sheath defines a plurality of apertures through a side wall thereof and is configured to provide the at least one of suction or irrigation through the plurality of apertures.

In another aspect of the present disclosure, the surgical instrument further includes an energizable member coupled to the sheath and extending distally therefrom. The energizable member is configured to move with the sheath between the retracted position, wherein the energizable member is positioned proximally of the first and second jaw members, and an extended position, wherein the energizable member extends distally from the first and second jaw members.

In yet another aspect of the present disclosure, the energizable member is configured to selectively supply monopolar energy to tissue.

In still another aspect of the present disclosure, the energizable member defines a hook-shaped configuration or a spatula-shaped configuration.

In another aspect of the present disclosure, the surgical instrument further includes a fluid jet member coupled to the sheath and extending distally therefrom. The fluid jet member is configured to move with the sheath between the retracted position, wherein the fluid jet member is positioned proximally of the first and second jaw members, and an extended position, wherein the fluid jet member extends distally from the first and second jaw members. The fluid jet member is configured to provide a fluid jet stream.

In still yet another aspect of the present disclosure, at least one of the first or second jaw members is configured to connect to a source of energy for treating tissue grasped therebetween. In such aspects, the first and second jaw members may be configured to connect to a source of bipolar electrosurgical energy for conducting energy therebetween to treat tissue grasped therebetween.

DETAILED DESCRIPTION

Referring generally toFIGS. 1-9, multi-function surgical instruments provided in accordance with the present disclosure are configured to operate in a first mode, e.g., for grasping tissue, treating grasped tissue with bipolar energy, and/or mechanically dissecting grasped tissue, and a second mode, e.g., for treating tissue and/or electrically/electromechanically dissecting tissue with monopolar, thermal, microwave, or other suitable energy. Instrument10further provides suction and/or irrigation capability before, during, after, and/or in place of the first and second modes of operation.

With reference toFIGS. 1-4, a multi-function surgical instrument provided in accordance with the present disclosure is shown generally identified by reference numeral10. Instrument10includes a housing20, a handle assembly30, a trigger assembly60, a rotation assembly70, an elongated shaft assembly80, an end effector assembly100, a drive assembly140, a knife assembly160, first and second activation assemblies170,180, respectively, a deployable assembly200, and a deployment and retraction mechanism300.

Instrument10also includes an electrosurgical cable (not shown) that connects instrument10to a generator (not shown) or other suitable power source. The electrosurgical cable includes wires (not shown) extending therethrough that have sufficient length to extend through housing20and/or elongated shaft assembly80in order to provide energy to at least one of the electrically-conductive surfaces112,122of jaw members110,120, respectively, of end effector assembly100, e.g., upon activation of first activation switch172of first activation assembly170in the first mode of operation. Similarly, one or more of the wires of the electrosurgical cable extends through housing20and/or elongated shaft assembly80in order to provide energy to energizable member220of deployable assembly200, e.g., upon activation of either of the second activation switches182of second activation assembly180in the second mode of operation.

Instrument10further includes a fluid port410disposed on housing20that enables connection of instrument10to a suction and/or irrigation source400via suitable tubing “T” (integral or removable tubing “T”). Within housing20, an internal fluid line420connects fluid port410with the interior of sheath210of deployable assembly200to enable the delivery of fluid to and/or withdrawal of fluid from the interior of sheath210. More specifically, suction and/or irrigation source400may be configured to only provide suction or irrigation through sheath210. Alternatively, suction and/or irrigation source400may be configured to provide, in a first configuration, suction though sheath210, and, in a second configuration, irrigation though sheath210. Instrument10may further include controls (not shown) such as ON/OFF buttons, adjustable buttons, etc. for controlling suction and/or irrigation. The controls may be disposed on housing20, on another portion of instrument10, or may be remote from instrument10, e.g., on the suction and/or irrigation source400.

Elongated shaft assembly80extends distally from housing20and supports end effector assembly100at a distal end thereof. End effector assembly100includes opposing jaw members110,120pivotably coupled to one another. Each of the jaw members110,120includes an electrically-conductive surface112,122adapted to connect to the source of energy and defines a bipolar configuration in use wherein surface112is charged to a first electrical potential and surface122is charged to a second, different electrical potential such that an electrical potential gradient is created for conducting energy between surfaces112,122and through tissue grasped therebetween for treating tissue. First activation switch172of first activation assembly170(FIG. 1) is operably coupled between the source of energy (not shown) and surfaces112,122via one or more wires (not shown), thus allowing the surgeon to apply energy, e.g., bipolar electrosurgical energy, to surfaces112,122of jaw members110,120, respectively, of end effector assembly100during the fist mode of operation.

Handle assembly30includes a movable handle40and a fixed handle50. Movable handle40is movable relative to fixed handle50between an initial position, wherein movable handle40is spaced-apart from fixed handle50, and a compressed position, wherein movable handle40is compressed towards fixed handle50. Drive assembly140is operably coupled between handle assembly30and end effector assembly100such that movement of movable handle40between the initial position and the compressed position pivots jaw member110relative to jaw member120between the spaced-apart position and the approximated position. Bilateral configurations of jaw members110,120are also contemplated.

Continuing with reference toFIGS. 1-4, trigger62of trigger assembly60is selectively actuatable relative to housing20from an un-actuated position to an actuated position. Knife assembly160is operably coupled to trigger62such that actuation of trigger62from the un-actuated position to the actuated position translates a knife (not shown) of knife assembly160from a retracted position, wherein knife162is disposed proximally of jaw members110,120, to an extended position, wherein knife162extends at least partially between jaw members110,120and through knife channels (not shown) defined within jaw members110,120to cut tissue grasped between jaw members110,120.

Rotation of rotation wheel72of rotation assembly70relative to housing20effects corresponding rotation of elongated shaft assembly80, end effector assembly100, drive assembly140, knife assembly160, and deployable assembly200relative to housing20.

Deployable assembly200includes a sheath210and an energizable member220. Sheath210, in embodiments, is insulative, although other configurations are also contemplated. Sheath210is movable relative to end effector assembly100between a retracted position, wherein sheath210is disposed proximally of end effector assembly100, and a extended position, wherein sheath210is substantially disposed about end effector assembly100. Energizable member220is coupled to the source of energy (not shown) and second activation assembly180(FIG. 1) via one or more wires (not shown) and may function as the active electrode of a monopolar circuit or may be energizable with any other suitable form of energy, e.g., thermal, microwave, etc. Energizable member220is movable together with sheath210and relative to end effector assembly100between a retracted position, wherein distal tissue-treating portion227of energizable member220is positioned more-proximally, and a extended position, wherein distal tissue-treating portion227of energizable member220extends distally from end effector assembly100to facilitate treating tissue therewith. Energizable member220, more specifically, is engaged with sleeve210such that energizable member220and sleeve210move together between their respective retracted and extended positions (collectively the retracted and extended positions of deployable assembly200). In the extended position, in embodiments where sheath210is insulative, sheath210serves to electrically insulate end effector assembly100from distal tissue-treating portion227of energizable member220, while distal tissue-treating portion227extends distally from end effector assembly100. In the extended position, energy may be supplied to distal tissue-treating portion227of energizable member220, e.g., via activation of either of the activation switches182of second activation assembly180(FIG. 1), for treating tissue in the second mode of operation.

Sheath210, as noted above, is coupled to suction and/or irrigation source400via internal fluid line420, fluid port410, and tubing “T” to enable the delivery of fluid to and/or withdrawal of fluid from the interior of sheath210. As such, fluid may be suctioned from a surgical site into the open distal end of sheath210and through sheath210and/or may be supplied to the surgical site via the open distal end of sheath210. Suction and/or irrigation may be provided in the retracted position of deployable assembly200, in the extended position of deployable assembly200, or in both the retracted and extended positions of deployable assembly200. Thus, suction and/or irrigation may be provided before, during, and/or after use of instrument10in the first mode of operation and/or second mode of operation.

Deployment and retraction mechanism300is configured for selectively transitioning deployable assembly200between its retracted position and its extended position. Deployment and retraction mechanism300generally includes a gear box310mounted within housing20, a gear assembly320operably disposed within gear box310, a pair of input shafts330operably coupled to gear assembly320and extending transversely from either side of gear box310and outwardly from housing20through apertures defined through housing20(only one side of housing20and, thus, one input shaft330is illustrated), a pair of deployment paddles340operably coupled to the input shafts330(only one side of housing20and, thus, one paddle340is illustrated), and a slider360disposed within housing20and operably coupling an output of gear assembly330with energizable member220of deployable assembly200(which, in turn, is engaged with sheath210) such that deployment and retraction mechanism300is configured to enable both deployment and retraction of deployable assembly200in a push-push manner, e.g., wherein deployable assembly200is both deployed and retracted by pushing either of paddles340in the same direction. Other suitable deployment mechanisms are also contemplated.

Referring toFIG. 5, another multi-function surgical instrument provided in accordance with the present disclosure is shown generally identified by reference numeral1010. Instrument1010is similar to instrument10(FIG. 1) and may include any of the features thereof. Thus, for purposes of brevity, only the differences between instrument1010and instrument10(FIG. 1) are described in detail below while similarities are summarily described or omitted entirely.

Instrument1010is configured to operate in a first mode, e.g., for grasping tissue, treating grasped tissue with energy, and/or mechanically dissecting grasped tissue (similarly as detailed above with respect to instrument10(FIG. 1)), and a suction/irrigation mode, e.g., to provide suction and/or irrigation at a surgical site. More specifically, deployable assembly1200of instrument1010includes a sheath1210(but does not include an energizable member as with instrument10(FIG. 1)). Sheath1210is movable relative to end effector assembly1100between a retracted position, wherein sheath1210is disposed proximally of end effector assembly1100, and a extended position, wherein sheath1210is substantially disposed about end effector assembly1100.

Sheath1210of deployable assembly1200is coupled to a suction and/or irrigation source (see source400(FIG. 1)) to enable the delivery of fluid to and/or withdrawal of fluid from the surgical site via open distal end of sheath1210. Suction and/or irrigation may be applied through sheath1210in the retracted position of sheath1210, in the extended position of sheath1200, or in both the retracted and extended positions of sheath1210. Thus, suction and/or irrigation may be provided before, during, and/or after use of instrument10in the first mode of operation.

Turning toFIG. 6, another multi-function surgical instrument provided in accordance with the present disclosure is shown generally identified by reference numeral2010. Instrument2010is similar to instrument10(FIG. 1) and may include any of the features thereof. Thus, for purposes of brevity, only the differences between instrument2010and instrument10(FIG. 1) are described in detail below while similarities are summarily described or omitted entirely.

Deployable assembly2200of instrument2010includes a sheath2210and an energizable member2220. Sheath2210of deployable assembly2200is coupled to a suction and/or irrigation source (see source400(FIG. 1)) to enable the delivery of fluid to and/or withdrawal of fluid from the interior of sheath2210. Energizable member2220is coupled to the source of energy (not shown) and may function as the active electrode of a monopolar circuit or may be energizable with any other suitable form of energy, e.g., thermal, microwave, etc. In other embodiments, energizable member2220is not energizable (and, thus, not coupled to a source of energy) but, rather, is configured as a mechanical component configured to facilitate manual, mechanical manipulation of tissue. Energizable member2220defines a spatula-shaped configuration including relatively broad opposing surfaces2222and relatively narrow peripheral edges2224. However, other suitable configurations (energizable or non-energizable) are also contemplated, e.g., a hook-shaped configuration (like energizable member220(FIG. 2)), ball-shaped configuration, needle-shaped configuration, etc.

With reference toFIG. 7, another multi-function surgical instrument provided in accordance with the present disclosure is shown generally identified by reference numeral3010. Instrument3010is similar to instrument10(FIG. 1) and may include any of the features thereof. Thus, for purposes of brevity, only the differences between instrument3010and instrument10(FIG. 1) are described in detail below while similarities are summarily described or omitted entirely.

Deployable assembly3200of instrument3010includes a sheath3210and an energizable member3220. Energizable member3220may be configured similarly as energizable member220(FIG. 2), energizable member2200(FIG. 6), any other suitable energizable member, a mechanical component without energization such as those detailed herein, or may be omitted entirely. Sheath3210of deployable assembly3200includes a distal portion3212defining a plurality of apertures3216through cylindrical side wall3214thereof. Apertures3216permit passage of fluid therethrough into and out of the interior of sheath3210. Sheath3210of deployable assembly3200is coupled to a suction and/or irrigation source (see source400(FIG. 1)) to enable the delivery of fluid to and/or withdrawal of fluid from the surgical site via sheath3210, e.g., via the open distal end of sheath3210and/or via apertures3216. Distal portion3212of sheath3210, which includes apertures3216, may be defined as the portion of sheath3210that extends distally from end effector assembly3100in the extended position of deployable assembly3200, or may extend further proximally about sheath3210. Apertures3216may be arranged in any suitable pattern, may extend annularly about the entire circumference of sheath3210or just a portion thereof, e.g., apertures3216may extend about 90 degrees, 180 degrees, or 270 degrees of the circumference of sheath3210, or may intermittently be disposed about sheath3210, e.g., to deliver or suction fluid from opposed lateral sides of sheath3210.

As illustrated inFIG. 8, another multi-function surgical instrument provided in accordance with the present disclosure is shown generally identified by reference numeral4010. Instrument4010is similar to instrument10(FIG. 1) and may include any of the features thereof. Thus, for purposes of brevity, only the differences between instrument4010and instrument10(FIG. 1) are described in detail below while similarities are summarily described or omitted entirely.

Deployable assembly4200of instrument4010includes a sheath4210and a fluid jet member4220. Sheath4210may be configured similarly as any of the other sheaths detailed herein or in any other suitable manner. In other embodiments, sheath4210is omitted entirely. With additional reference toFIG. 9, sheath4210, in embodiments where provided, is coupled to a suction source (see source400(FIG. 1)) via first internal fluid line4420, first fluid port4410, and tubing “T” to enable the withdrawal of fluid from a surgical site into the open distal end of sheath4210and through the interior of sheath4210. Suction may be applied through sheath4210in the retracted position of deployable assembly4200, in the extended position of deployable assembly4200, or in both the retracted and extended positions of deployable assembly4200. Thus, suction may be provided before, during, and/or after use of instrument10in the first mode of operation.

Continuing with reference toFIGS. 8 and 9, fluid jet member4220is movable together with sheath4210and relative to end effector assembly4100between a retracted position, wherein distal nozzle portion4227of fluid jet member4220is positioned more-proximally, and a extended position, wherein distal nozzle portion4227of fluid jet member4220extends distally from end effector assembly2100to facilitate supplying fluid to a surgical site. Fluid jet member4220is configured as fluid tube and may include distal nozzle portion4227to facilitate delivering fluid in the form of a jet stream, e.g., to clear blood, debris, etc. from the surgical site, to blast debris or tissue with the surgical site, and/or to cut through delicate tissue. As an alternative to a fluid jet, member4220may deliver fluid in any other suitable manner.

Fluid jet member4220is coupled to a fluid source (see source400(FIG. 1) or a separate source) via second internal fluid line4440, second fluid port4430, and tubing “T” to enable the supply of fluid to fluid jet member4220for application to a surgical site in the form of a fluid jet stream. Fluid jet member4220and/or the source may be configured to provide a variable, controllable pressure and/or flow rate of the fluid jet stream. The fluid may be water, saline, air, CO2, medicament, cryogenic fluid, a surgical adhesive, or other suitable liquid or gas. Fluid may be supplied from fluid jet member4220in the retracted position of deployable assembly4200, in the extended position of deployable assembly4200, or in both the retracted and extended positions of deployable assembly4200. Thus, fluid may be provided before, during, and/or after use of instrument10in the first mode of operation.

Turning back toFIG. 1, as opposed to handheld, manual manipulation and operation, the various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.