Surgical instruments

Abstract: A surgical instrument for clamping, shearing, cutting or a variety of other tasks is comprised of a tube (12) having a moveable jaw (30) and a fixed jaw (24) at a distal end and a pair of opposed, cooperating actuating handles (40) at a proximal end for operating the moveable jaw by way of a pull and push rod (18). The moveable jaw is normally in the open position. Because at least one of the actuating handles is resiliently flexible and the actuating handles are normally bowed outward, squeezing them together produces displacement of the rod which causes the moveable jaw to pivot about its connection to the fixed jaw resulting in the closure of the two jaws together. Preferably, the surgical instrument has a removable end piece (52) fitted in the proximal end of the elongated tube. The end piece provides support for the rod, prevents the accumulation of debris within the elongated tube and is easily removable to allow for cleaning of the instrument.

Description: This invention relates generally to the field of surgical instruments for performing cutting, clamping, holding or shearing functions in surgical operations. Delicate surgical operations such as microsurgery and laparoscopic surgery often require precise control over jaws or blades of instruments used in the procedure. Heretofore, few surgical instruments have been designed which provide such precise control. In order to achieve maximum control over these instruments, it is necessary to use the muscles that control motion of the fingers because they are capable physiologically of more precise control and remarkable finesse. While US-A-4 760 848 and US-A-4 898 157 do disclose surgical instruments which exploit these more sensitive muscles, the instruments are unnecessarily complex and, thus, are relatively expensive and difficult to clean properly. Therefore, there is a need to develop surgical instruments which utilize the hand muscles capable of providing enhanced control of the instrument yet are easy to clean and are relatively inexpensive. An object of the present invention is to provide a surgical instrument which can be easily held in the hand for use in delicate surgery. According to the present invention, a surgical instrument comprises an elongated tubular member having a first end and a second end, a moveable working member at said first end of said tubular member, a pair of actuating members, at least one of which is resiliently flexible, each having a first end and a second end and being connected at their first ends to said tubular member at a point spaced from said first end of said tubular member, said actuating members extending beyond said second end of said tubular member and being operably connected to each other proximate their said second ends, and a linkage rod slidably positioned in said tubular member and connected to said moveable working member and extending through said tubular member and beyond said second end thereof and being operably connected to said resiliently flexible actuating member whereby lateral compression of said flexible actuating member toward the other actuating member causes said linkage rod to move said working member. Thus, in a preferred construction, the instrument has a pair of opposed actuating handles, at least one of which is resiliently flexible, connected at their first ends to the tube and operably connected proximate their second ends to each other at a point spaced from the tube. A linkage rod slidably positioned within the elongated tube is pivotally connected at one end to a moveable member and is operably connected at the other end to at least said flexible actuating handle. Both handles may be resiliently flexible and then, in operation, the lateral compression of the resiliently flexible actuating handles, which are normally bowed outward from one another, causes the linkage rod to move in relationship to the elongated tube which, in turn, causes the moveable member to move. Release of pressure allows the flexible handles to flex back to their original position, moving the linkage member and the moveable member back to their original positions. In alternative constructions, one of the handles is rigid while the other is rigidly flexible and compression of the flexible handle towards the rigid handle causes the linkage rod to move. The moveable member of the instrument can be adapted relative to a fixed member or another moveable member to facilitate clamping, shearing, holding, cutting or a variety of other tasks. The invention may be carried into practice in various ways but one surgical instrument embodying the invention, together with a modified instrument also embodying the invention, will now be described by way of example with reference to the accompanying drawings, in which: Fig. 1 is a plan view of the instrument; Fig. 2 is a plan view of the handle of the instrument; Fig. 3 is a fragmentary cross-sectional view of the jaws of the instrument; Fig. 4 is a cross-sectional view of the handle of the instrument taken along the lines IV-IV in Fig. 2; and Fig. 5 is a plan view of the handle of the modified instrument. Referring now to the drawings, Fig. 1 shows a surgical instrument 10 including an elongated tube 12 having a tube first end 14 and a tube second end 16, a pair of opposing actuating members 40, a moveable jaw 30, a fixed jaw 24 and a linkage rod 18 connecting the actuating members 40 with the moveable jaw 30. The elongated tube 12, moveable jaw 30, fixed jaw 24 and the linkage rod 18 are preferably made of metal, but also could be of other appropriate materials. The opposing actuating members 40 are preferably constructed from a resilient sheet metal such as stainless steel. The gauge of the material is chosen so as to provide sufficient flexibility that plastic deformation of the tool does not occur in normal use (hence the term "resiliently flexible" hereinafter), and to provide the desired spring rate, according to the intended use of the tool. Because all of the instrument components can be made from metal, their manufacture is very straightforward and inexpensive. In addition, the instrument is easily and thoroughly cleaned and sterilized. For purposes of description herein, the term "distal" shall refer to that portion of instrument 10 or a component thereof which is situated or moved furthest away from the body of the operator of instrument 10. The term "proximal," on the other hand, shall refer to that portion of instrument 10 or a component thereof which is situated or moved closest to the body of the operator. As shown in Fig. 3, fixed jaw 24 has a proximal end 26 and a distal end 28 and moveable jaw 30 has a proximal end 32 and a distal end 34. As seen in Fig. 3, proximal end 26 of fixed jaw 24 is inserted into tube first end 14 to attach fixed jaw 24 to tube 12. Proximal end 32 of moveable jaw 30 is attached to proximal end 26 of fixed jaw 24 by a first pivot pin 36 which allows for moveable jaw 30 to pivot around the axis of first pivot pin 36. Figs. 1, 2, 3 and 4 show that linkage rod 18, which has a rod first end 20 and a rod second end 22, is slidably positioned within tube 12. A second pivot pin 38 attaches rod first end 20 to moveable jaw 30 at a point spaced from the point of attachment of moveable jaw 30 to fixed jaw 24 by first pivot pin 36. Pivot pin 38 and pivot pin 36 are oriented so that movement of linkage rod 18 causes the movement of moveable jaw 30 about the axis of first pivot pin 36 and so that rod 18 can bias moveable jaw 30 towards the "open" position. With reference to Figs. 1, 2 and 4, a girdle 48 is attached to tube 12 at a point located between tube first end 14 and tube second end 16 of tube 12. Opposing actuating members 40, each having a first end 42 and a second end 44, are attached to girdle 48 at the first ends 42 of actuating members 40 by connecting pins 50. Second ends 44 of actuating members 40 extend beyond tube second end 16 and are operably connected to each other by a locking pin 54. Linkage rod 18 extends proximally through tube 12 and beyond tube second end 16 through an end cap 52. Second end 22 of linkage rod 18 is operably connected to second ends 44 of actuating members 40. End cap 52 is placed in tube second end 16 to provide support for rod 18 and to prevent debris from entering the interior of tube 12. The end cap 52 is removable to assist cleaning of the instrument. In operation, compression of the normally outwardly bowed actuating members 40 towards each other causes the proximal movement of linkage rod 18 with respect to tube 12. The movement of linkage rod 18 is guided slidingly within the hollow portion of tube 12 by end cap 52. The proximal movement of linkage rod 18 effects the proximal movement of moveable jaw 30 which causes the rotation of moveable jaw 30 about pivot pin 36 and results in the movement of moveable jaw 30 toward fixed jaw 24. Release of actuating members 40 causes the resiliently flexible actuating members 40 to return to their original open position. This return to the original open position causes the distal movement of linkage rod 18 with respect to tube 12 and the return of moveable jaw 30 back to the "open" position. In an alternative construction shown in Fig. 5, a flexible actuating member 140 having a first end 141 and a second end 142 and a rigid actuating member 144 having a first end 145, a second end 146 and an interior side 147 are attached to girdle 48 at first end 141 of flexible actuating member 140 and first end 145 of rigid actuating member 144 by connecting pins 50. Second end 146 of rigid actuating member 144 and second end 142 of flexible actuating member 140 each extend beyond tube second end 16 with second end 142 of flexible actuating member 140 being operably connected to rigid actuating member 144 by a roller 160 which contacts side 147. Second end 22 of linkage rod 18 is operably connected to flexible actuating member 140 near second end 142 and roller 160. In operation, compression of the normally outwardly bowed flexible actuating member 140 toward the normally outwardly bowed rigid actuating member 144 causes roller 160 to slide proximally along interior side 147 of rigid actuating member 144. Two motions are associated with the proximal movement of flexible actuating member 140: proximal/distal and up/down. Since the only desired motion is the motion needed to move linkage rod 18 proximally and distally, the up/down motion must be dissipated. This is accomplished by fitting flexible actuating member 140 through an angled eyelet 162 located at the second end 22 of linkage rod 18. The angle at which eyelet 162 is cut in second end 22 of linkage rod 18 allows flexible actuating member 140 to slide up and down relative to linkage rod 18 while at the same time causing the proximal movement of linkage rod 18 with respect to tube 12. The movement of linkage rod 18 is guided slidingly within the hollow portion of tube 12 by end cap 52. The proximal movement of linkage rod 18 effects the proximal movement of moveable jaw 30 which causes the rotation of moveable jaw 30 about pivot pin 36 and results in the movement of moveable jaw 30 toward fixed jaw 24. Release of flexible actuating member 140 causes it to return to its original outwardly bowed position. This return to the original open position causes flexible actuating member 140 to slide down with respect to linkage rod 18 and causes the distal movement of linkage rod 18 with respect to tube 12 and the return of moveable jaw 30 back to the "open" position. While the foregoing describes use of the instrument in the field of surgery, the instrument may find appropriate uses in other applications requiring a small, simple jawed tool. It should be understood that moveable jaw 30 and fixed jaw 24 are just an example and that cutting blades, saw blades, needle holders, scissors, tissue forceps, smooth holding platforms, etc., could be substituted for these jaws.

Claims: A surgical instrument comprising an elongated tubular member (12) having a first end (14) and a second end (16); a moveable working member (30) at said first end (14) of said tubular member; a pair of actuating members (40,40;140,144), at least one of which is resiliently flexible, and having a first end (42;141,145) and a second end (44;142,146) and being connected at their first ends to said tubular member (12)at a point spaced from said first end (14) of said tubular member, said actuating members extending beyond said second end (16) of said tubular member and being operably connected to each other proximate their said second ends, and a linkage rod (18) slidably positioned in said tubular member (12) and connected to said moveable working member (30) and extending through said tubular member and beyond said second end (16) thereof and being operably connected to said resiliently flexible actuating member whereby lateral compression of said flexible actuating member toward the other actuating member causes said linkage rod to move said working member. A surgical instrument according to claim 1 in which compression of said actuating members causes said linkage rod to move outwardly from said tubular member. A surgical instrument according to claim 1 or claim 2 in which the moveable working member is a jaw for clamping or is a blade for cutting. A surgical instrument according to claim 1 or claim 2 in which the moveable working member (30) is a moveable jaw pivoted to the first end (14) of the tubular member (12) and pivotally connected to the linkage rod (18), and which includes a fixed jaw fixed to the first end (14) of the tubular member (12) and cooperating with the moveable jaw to provide a clamp. A surgical instrument according to any of claims 1 to 4 which includes a removable end piece (52) fitted in said second end (16) of said elongated tubular member whereby said end piece provides support for said linkage rod (18). A surgical instrument according to any of claims 1 to 5 in which said actuating members are normally bowed outward from one another. A surgical instrument according to any of claims 1 to 6 in which both of said actuating members (40) are resiliently flexible. A surgical instrument according to any of claims 1 to 6 in which one (140) of said actuating members is resiliently flexible and the other (144) of said actuating members is rigid. A surgical instrument according to claim 8 in which said flexible actuating member (140) is slidably connected (162) to said linkage rod (18). A surgical instrument according to claim 8 or claim 9 in which said flexible actuating member (140) is slidable (160) on said rigid actuating member (144).

Inventors: HOOGEBOOM JAMES E, HOOGEBOOM THOMAS J, HOOGEBOOM, JAMES E., HOOGEBOOM, THOMAS J.
Applicants: HOOGEBOOM JAMES E, HOOGEBOOM THOMAS J, HOOGEBOOM, JAMES E., HOOGEBOOM, THOMAS J.
Application year: 1993
Main classification: A61B17
IPC codes: A61B17