# Patent

## Title
Detachable end effector and loader

## Abstract

A surgical device comprises an elongate shaft having an outer tube and an inner rod positioned in the outer tube. The outer tube and inner rod each comprise a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the elongate shaft. The end effector comprises an outer casing comprising a first detent mating feature adapted to engage the distal end of the outer tube; an inner shuttle axially moveable relative the outer casing, the shuttle comprising a second detent mating feature adapted to engage the distal end of the inner rod; and a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing. A tubular loader is sized to receive the end effector, the tubular loader comprising third detent mating feature adapted engage end effector.

## Background
BACKGROUND
The present invention relates in general to surgical devices and procedures, and more particularly to minimally invasive surgery.
Surgical procedures are often used to treat and cure a wide range of diseases, conditions, and injuries. Surgery often requires access to internal tissue through open surgical procedures or endoscopic surgical procedures. The term “endoscopic” refers to all types of minimally invasive surgical procedures including laparoscopic, arthroscopic, natural orifice intraluminal, and natural orifice transluminal procedures. Endoscopic surgery has numerous advantages compared to traditional open surgical procedures, including reduced trauma, faster recovery, reduced risk of infection, and reduced scarring. Endoscopic surgery is often performed with an insufflatory fluid present within the body cavity, such as carbon dioxide or saline, to provide adequate space to perform the intended surgical procedures. The insufflated cavity is generally under pressure and is sometimes referred to as being in a state of pneumoperitoneum. Surgical access devices are often used to facilitate surgical manipulation of internal tissue while maintaining pneumoperitoneum. For example, trocars are often used to provide a port through which endoscopic surgical instruments are passed. Trocars generally have an instrument seal, which prevents the insufflatory fluid from escaping while an instrument is positioned in the trocar.
While a variety of different minimally invasive surgical devices are known, no one has previously made or used the surgical devices and methods in accordance with the present invention.
SUMMARY
In one embodiment, a surgical device comprises an elongate shaft having an outer tube and an inner rod positioned in the outer tube. The outer tube and inner rod each comprise a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the elongate shaft. The end effector comprises an outer casing comprising a first detent mating feature adapted to engage the distal end of the outer tube; an inner shuttle axially moveable relative the outer casing, the shuttle comprising a second detent mating feature adapted to engage the distal end of the inner rod; and a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing. A tubular loader is sized to receive the end effector, the tubular loader comprising third detent mating feature adapted engage end effector.
The first, second, and third detent mating features may have a threshold disengagement force F1, F2, and F3, respectively, of the following relative magnitudes: F1<F3<F2. The first detent mating feature may comprise a leaf spring on the outer casing adapted to engage a notch on the outer tube. The third detent mating feature may comprise a leaf spring on the tubular loader adapted to engage a notch on the outer casing. The second detent mating feature may comprise a pair of proximally oriented prongs, each having a medially oriented tooth adapted to engage a notch on the inner rod. The distal end of the outer tube may comprise a sloped surface adapted to engage and laterally spread the prongs thereby disengaging the teeth from the notch on the inner rod.
In another embodiment, a surgical device comprises an elongate shaft comprising an outer tube and an inner rod positioned in the outer tube, the outer tube and inner rod each comprising a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the elongate shaft. The end effector comprises an outer casing comprising a first mating feature adapted to engage the distal end of the outer tube; an inner shuttle axially moveable relative the outer casing, the shuttle comprising a second mating feature adapted to engage the distal end of the inner rod; and a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing. The second mating feature comprises a pair of proximally oriented prongs, each having a medially oriented tooth adapted to engage a notch on the inner rod. The distal end of the outer tube comprises a sloped surface adapted to engage and laterally spread the prongs thereby disengaging the teeth from the notch on the inner rod. The first mating feature may comprise a detent mechanism.
In yet another embodiment, a surgical device comprises an elongate shaft comprising an outer tube and an inner rod positioned in the outer tube, the outer tube and inner rod each comprising a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the elongate shaft. The end effector comprises an outer casing and a means to attach the outer casing to the outer tube; an inner shuttle axially moveable relative the outer casing and a means to attach the shuttle to the inner rod; and a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing. A tubular loader is sized to receive the end effector and includes a means to attach the end effector in the tubular loader.



BRIEF DESCRIPTION OF DRAWINGS
While the specification concludes with claims which particularly point out and distinctly claim the invention, it is believed the invention will be better understood from the following description taken in conjunction with the accompanying drawings illustrating some non-limiting examples of the invention. Unless otherwise indicated, the figures are not necessarily drawn to scale, but rather to illustrate the principles of the invention.
FIG. 1 depicts an example of a loader, end effector, shaft, and actuator;
FIG. 2 depicts an exploded view of the shaft;
FIG. 3 depicts a cross-sectional view of a portion of the shaft;
FIG. 4 depicts a perspective view of the end effector;
FIG. 5 depicts an exploded view of the end effector;
FIG. 6 depicts a side view of the loader and end effector;
FIG. 7 depicts a cross-sectional view of the end effector locked in the loader; and
FIG. 8 depicts a cross-sectional view of the end effector attached to the shaft and unlocked in the loader.



DETAILED DESCRIPTION
The figures illustrate one example a laparoscopic surgical instrument system. The elongate shaft (20) comprises an outer tube (23) and an inner rod (24) positioned in the outer tube (23). The elongate shaft comprises a distal end (21) and a proximal end (22). The elongate shaft (20) may be rigid and adapted for insertion into a body cavity through an access device, such a trocar, or through direct percutaneous insertion without an access device. The elongate shaft (20) may also be flexible and sized for insertion through the working channel of a flexible endoscope. The rigid shaft embodiment is well suited for laparoscopic surgical procedures, and the flexible shaft embodiment is well suited for natural orifice intraluminal and natural orifice transluminal procedures.
An actuator (30) is operably connected to the proximal ends (22) of the outer tube (23) and the inner rod (24). The actuator (30) causes the inner rod (24) to move relative the outer tube (23). In this embodiment the actuator (30) is a manual pistol grip handle; however, a variety of other manual actuators could also be used, including a scissor grip handle, a syringe grip handle, endoscopic rotary knobs, and the like. The actuator (30) could also take the form of a robotic interface, such as an DAVINCI puck, a housing comprising gears or pulleys, servomechanisms, and the like.
The end effector (10) is adapted for in vivo attachment to and detachment from the elongate shaft (20). An inner shuttle (14) is axially moveable relative the outer casing (12). The shuttle comprises a mating feature adapted to attach to the distal end of the inner rod (24). The specific mating feature can vary, but in this embodiment the mating feature comprises a detent-type mechanism comprising a pair of proximally oriented prongs (14A), each functioning as leaf spring to bias a medially oriented tooth (14B) to engage the notch (27B) on the inner rod (24).
A pair of surgical jaws (11A, B) have an opened position and closed position dependant on the relative axial position of the shuttle (14) and the outer casing (12). A clevis (15) is fixed to the outer casing (12). A bar linkage mechanism (13) cooperates with the clevis (15) to translate the axial motion of the shuttle (14) to open and close the jaws (11); however, a variety of other known mechanisms can be used to effect operation of the jaws (11). In this embodiment, the jaws (11) are shown as a grasper; however, a variety of other tissue manipulating jaws could also be used, including dissectors, sheers, babcocks, forceps, staplers, clip appliers, and the like. Non-jawed end effectors could also be employed such as hook knives, snares, retractors, and the like. In the case of end effectors that require energy, appropriate energy transmission mechanisms known in the art can be added. For instance, appropriate electrical connections can be added between the shaft (20) and end effector (10) to enable bi-polar forceps. Similarly, an ultrasonic transducer and waveguide can be added for the ultrasonic shears end effector.
The end effector (10) comprises a mating feature (17) adapted to attach the outer casing (12) to the outer tube (23). In this embodiment the mating feature (17) is a detent-type mechanism comprising two leaf springs, positioned 180 degrees from each other on the outer casing (12), each having a medial facing tooth. As the outer tube (23) slides distally into the outer casing (12), and the leaf springs provide a biased snap-to-lock engagement of the teeth into the notch (27A). Other mating features could also be used, including threads, collets, bayonets, and the like. Keyway features (19) are sized and adapted to engage the spline features (28) on the outer tube (23) to facilitate rotational coupling when the outer tube (23) is attached to the outer casing (12).
A loader (40) comprises a handle (45), a shaft (43), and a distal tube (41) that may articulate relative the shaft (43). The tube (41) is sized to receive the end effector (10). The tube (41) comprises a mating feature (42) adapted to attach the end effector (10) inside the tube (41). In this embodiment the mating feature (42) is a detent-type mechanism comprising two leaf springs, positioned 180 degrees from each other on the tube (41), each having a medial facing tooth. As the end effector (10) slides into the tube (41), and the leaf springs provide a biased snap-to-lock engagement of the teeth into the notch (18). Other mating features could also be used, including threads, collets, bayonets, and the like.
The three mating features (17, 14A, and 42) each have a threshold axial force that will cause the respective components to disengage. For instance, the threshold disengagement force of the mating feature (17) is the axial force required to separate the outer housing (12) from the outer tube (23). Preferably, the relative magnitudes of the threshold disengagement forces are in accordance with the following equation:

F1<F3<F2 

where

    
    
        F1 is the threshold disengagement force between the outer housing (12) and the outer tube (23);
        F2 is the threshold disengagement force between the shuttle (14) and inner rod (24);
        F3 is the threshold disengagement force between the loader tube (41) and the end effector (10);

During surgery, the distal end (21) of the shaft (20) is inserted into the body cavity, such as the abdomen, pelvis, thorax, etc. The end effector (10) is attached into the tube (41) and also introduced into the body cavity, typically through an access port. The loader tube (41) can be articulated to facilitate bringing the end effector (10) into axial alignment with the shaft (20). The distal end (21) is then inserted into the end effector (10). The outer tube (23) slides distally into the outer casing (12) until the leaf springs of the mating feature (17) provide a biased snap-to-lock engagement into the notch (27A), thus attaching the outer casing (12) to the outer tube (23). The inner rod (24) slides distally into the shuttle (14) until the prongs (14A) provide a biased snap-to-lock engagement with the teeth (14B) into the notch (27B), thus attaching the shuttle (14) to the inner rod (24). The end effector (10) is now fully attached in vivo to the shaft (20) and can then be pulled from the tube (41). Because F2>F1, pulling the shaft (20) proximally will cause the end effector (10) to be pulled out the loader tube (41). The loader (40) can be removed from the surgical field. Operation of the actuator (30) translates to operate the jaws (11), thus enabling a surgeon to manipulate tissue and perform minimally invasive surgical procedures.

    
    


In vivo detachment is achieved by reversing the attachment steps outlined in the previous paragraph. The loader (40) is introduced into the body cavity and the end effector (10) is slid into the tube (41). The distal end (21) of the outer tube (23) comprises a sloped surface (29). When the slider (25) is advanced distally and compresses the spring (26), the sloped surface (29) also advances distally to engage and laterally spread the shuttle prongs (14A) thus disengaging the teeth (14B) from the notch (27B) on the inner rod (24). The pin (25A) slides in L-shaped slot, enabling the surgeon to keep the sloped surface (29) in its distal-most position. The inner rod (24) can now be pulled from the shuttle (14), effectively making F2 equal to zero (the sloped surfaces (29) may also be used to facilitate in vivo insertion of the inner rod (24) into the shuttle (14)). Because F3>F2, pulling the shaft (20) proximally will cause the end effector (10) to detach from the inner rod (24) leaving the end effector (10) attached inside the loader tube (41).
Having shown and described various embodiments and examples of the present invention, further adaptations of the methods and devices described herein can be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the specific materials, dimensions, and the scale of drawings will be understood to be non-limiting examples. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure, materials, or acts shown and described in the specification and drawings.

## Claims

1. A surgical device, comprising:
a) an elongate shaft comprising an outer tube and an inner rod positioned in the outer tube, the outer tube and inner rod each comprising a distal end and a proximal end;
b) an actuator operably connected to the proximal ends of the outer tube and the inner rod;
c) an end effector adapted for in vivo attachment to and detachment from the elongate shaft, the end effector comprising:
i) an outer casing comprising a first detent mating feature adapted to engage the distal end of the outer tube;
ii) an inner shuttle axially moveable relative the outer casing, the shuttle comprising a second detent mating feature adapted to engage the distal end of the inner rod, wherein the second detent mating feature comprises a pair of proximally oriented prongs, each having a medially oriented tooth adapted to engage a notch on the inner rod;
iii) a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing;

d) a tubular loader sized to receive the end effector, the tubular loader comprising third detent mating feature adapted engage end effector.

2. The surgical device of claim 1, wherein the first, second, and third detent mating features have a threshold disengagement force F1, F2, and F3, respectively, of the following relative magnitudes:


F1<F3<F2.

3. The surgical device of claim 1, wherein the first detent mating feature comprises a leaf spring on the outer casing adapted to engage a notch on the outer tube.

4. The surgical device of claim 1, wherein the third detent mating feature comprises a leaf spring on the tubular loader adapted to engage a notch on the outer casing.

5. The surgical device of claim 1, wherein the distal end of the outer tube comprises a sloped surface adapted to engage and laterally spread the prongs thereby disengaging the teeth from the notch on the inner rod.

6. The surgical device of claim 5, further comprising a pusher operably connected to the outer tube to advance the sloped surface distally.

7. The surgical device of claim 6, wherein a pin connect the outer tube to the pusher, and the pin rides in an L-shaped slot.

8. A surgical device, comprising:
a) an elongate shaft comprising an outer tube and an inner rod positioned in the outer tube, the outer tube and inner rod each comprising a distal end and a proximal end;
b) an actuator operably connected to the proximal ends of the outer tube and the inner rod;
c) an end effector adapted for in vivo attachment to and detachment from the elongate shaft, the end effector comprising:
i) an outer casing comprising a first mating feature adapted to engage the distal end of the outer tube;
ii) an inner shuttle axially moveable relative the outer casing, the shuttle comprising a second mating feature adapted to engage the distal end of the inner rod;
iii) a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing;

wherein the second mating feature comprises a pair of proximally oriented prongs, each having a medially oriented tooth adapted to engage a notch on the inner rod; and
wherein the distal end of the outer tube comprises a sloped surface adapted to engage and laterally spread the prongs thereby disengaging the teeth from the notch on the inner rod.

9. The surgical device of claim 8, wherein the first mating feature comprises a detent mechanism.