Abstract:
A surgical grasping instrument for grasping an elongated implement, which comprises a frame; an elongated member connected to the frame and extending distally therefrom, the elongated member defining a longitudinal axis; and a pair of jaw members operatively connected to the elongated member, the jaw members being adapted for movement between an open position and a closed position, at least one of the jaw members having a recess defined therein and arranged about a central recess axis extending at an angle of about 35° or less relative to the longitudinal axis of the elongated member, wherein upon movement of the jaw members to the closed position, the jaw members form a holding groove that can engage and firmly secure the elongated implement.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
   The present application claims priority of U.S. provisional application Ser. No. 60/273,522 filed Mar. 5, 2001, the entire contents of which is hereby incorporated by reference. 

   BACKGROUND 
   1. Technical Field 
   The present invention relates to surgical instruments, and more particularly, to an endoscopic grasping instrument having jaw members advantageously designed to engage and firmly secure a surgical implement at a desired orientation to facilitate manipulation of the implement about the surgical site, and/or mounting of the instrument to other surgical devices, for example, to a surgical stapler. 
   2. Background of Related Art 
   Circular anastomosis is the surgical joining of separate hollow body organ sections so that the sections intercommunicate. Typically, the anastomosis procedure follows surgery in which a diseased or defective section of hollow tissue is removed and the remaining end sections are to be joined. In accordance with such procedures, the operative tissue is exposed by making at least one extensive tissue incision, in the body cavity wall and folding the cut tissue back to provide access to the surgical site. The diseased section of the organ is removed thereby leaving two separate end sections of organ to be thereafter fastened by anastomosis by means of a stapling instrument. The stapling instrument drives a circular array of staples through the end sections and simultaneously cores out any overlapping tissue to free the tubular passages. 
   Examples of such instruments for performing anastomosis of hollow organs are described in U.S. Pat. Nos. 4,304,236, 4,379,457, 4,573,468, 4,576,167, 4,603,693 and 4,646,745, the entirety of each of which is incorporated herein by reference. In instruments of the types exemplified by these patents, opposed end portions of the organs to be stapled are clamped between an anvil component and a staple holding component (i.e., staple cartridge), both of which are located at the distal end of the anastomosis instrument. The clamped tissue is stapled by driving one or more staples from the staple cartridge so that the ends of the staples pass through the tissue and are clinched by the anvil component. 
   In a typical application of joining first and second intestinal sections together, the intestinal section in question is removed leaving the first and second intestinal end sections to be joined by anastomosis. The stapling instrument, having the anvil component operatively coupled thereto, is applied to the operative site. Each end of the intestinal sections to be attached is then secured to their respective stapler cartridge and anvil assembly by a well-known purse string stitch to cause the tissue portions to tighten and to remain on the apparatus in position for permanent attachment by the staples. Thereafter, the anvil component is manually brought into close proximity to the staple cartridge. The instrument is fired and the intestinal sections are attached by circular rows of staples or fasteners. 
   In some applications of the circular anastomosis technique, it is necessary to utilize a surgical instrument in which the anvil component, typically an anvil assembly comprised of an anvil head and a shaft, is detachably mounted to the staple cartridge. In such cases, the stapling instrument is introduced either surgically or transanally into the first intestinal section without the anvil assembly in place. The anvil assembly is subsequently surgically inserted within the second intestinal section. Both intestinal sections are then secured respectively to the anvil assembly and stapler cartridge by a drawstring type suture. It is then necessary to grasp and hold the shaft of the anvil assembly in order to properly mount the anvil assembly or component onto or within the cartridge assembly portion of the instrument. The instrument is then fired to complete the anastomosis. 
   However, the task of grasping the anvil and mounting it to the anastomosis instrument has proven to be quite difficult, particularly in restricted operative sites which are surrounded by close organs, tissue, etc. Conventional means incorporate the use of a conventional forceps or similar device. However known forceps typically include flat forceps jaw surfaces which are not suitable for grasping a round implant such as an anvil or anvil shaft. Also, the grasper jaws typically are disposed along the longitudinal axis of the forceps. Such a configuration often requires ample space in the abdominal cavity to grasp and manipulate the instrument. Further, the presence of body fluids, blood, etc. also complicate the procedure. 
   Accordingly, the present disclosure is directed to an endoscopic surgical instrument having jaws which are adapted to provide a secure grip of the shaft of or for an anvil together with enhanced freedom of movement of the surgical instrument within the patients&#39; body without slippage and/or interference with body organs or tissue of the patient, or other obstructions. Further, the surgical jaws are suitably disposed to provide improved holding of a cylindrical or rod-like object at a desired orientation in which the longitudinal central axis of the cylindrical or rod-like object is substantially parallel or slightly oblique with respect to the longitudinal central axis of the elongated shaft of the surgical instrument. Such a configuration requires less space in the abdominal cavity to grasp and manipulate the instrument. Yet further, the anvil shaft is suitably designed to facilitate mounting of the shaft to the anastomosis instrument. 
   SUMMARY 
   The surgical jaws according to the present invention are adapted for use with an endoscopic surgical instrument and are advantageously configured to facilitate grasping of a shaft of or for an anvil assembly of a circular surgical stapling device and manipulation of the anvil assembly about the operative site. Generally, the present invention is directed to a surgical instrument including a frame or handle member and an elongated shaft member that has a longitudinal axis, and is operatively coupled to the frame or handle member. 
   In a preferred embodiment, a pair of jaw members are operatively connected to the elongated member, and are adapted for movement between an open position and a closed position. At least one of the pair of jaw members includes a facing surface having a recess therein and arranged about a central recess axis extending at an angle of about 35° or less relative to the longitudinal axis of the elongated member. In use, upon movement of the jaw members to the closed position, the jaw members form a holding groove that engages and firmly secures an elongated implement therein. Each of the jaw members can have a recess formed therein. 
   Preferably, the central recess axis is about 25° relative to the longitudinal axis of the elongated member. 
   In a further preferred embodiment each jaw member includes a distal gripper portion wherein at least one distal gripper portion of the pair has the recess therethrough. Each distal gripper portion extends along an axis ranging from about 55° to about 75° relative to the longitudinal axis of the elongated member. Preferably, the axis of each gripper portion is about 65° relative to the longitudinal axis. 
   In an alternative preferred embodiment, according to the present invention, the endoscopic surgical instrument includes a frame member and an elongate shaft, wherein the elongate shaft has a proximal end operatively coupled to the frame member and a distal end. The elongate shaft defines a longitudinal axis. The endoscopic surgical instrument further includes an actuation mechanism coupled to the frame and jaw members, and includes a pair of jaw members operatively coupled to the distal end of the elongate shaft, the pair of jaw members being adapted to move between an open and a closed position. Each of the pair of jaw members includes a jaw axis and includes a distal gripper portion having a recess therein. The recesses are juxtaposed relative to one another for grasping a shaft of or for an anvil therein. As such, when the jaw members are in the closed position, the recesses define a holding groove having an axis that is oriented at an angle which is about 35° or less relative to the jaw axis. 
   Preferably, the axis of the holding groove is oriented at an angle which is between about 15° to about 35° relative to the jaw axis. More preferably, the axis of the holding groove is oriented at an angle which is about 25° relative to the jaw axis. The axis of the holding groove can be parallel to the jaw axis. 
   In a further embodiment, each jaw member of the endoscopic surgical instrument includes a base portion adapted to engage the distal end of the elongated shaft and a distal end portion having a longitudinal axis and that is located between the gripper portion and the base portion. The axis of the holding groove is oriented at an angle which is about 35° or less relative to the longitudinal axis of the distal end portion. Preferably, the axis of the holding groove is oriented at an angle which is about 25° relative to the jaw axis. The axis of the holding groove can be parallel to the jaw axis. 
   In yet another embodiment, each jaw member includes a base portion that has a diametric hole therethrough and about which the pair of jaws pivot and wherein each base portion includes a cam slot formed proximally of the diametric holes, wherein the cam slots cooperate with one another to transform an axial movement of the actuation means into the opening and closing of the pair of jaw members. 
   In still a further embodiment, each jaw member includes a base portion and an adjacent intermediate body portion that includes a distal end portion which is parallel to the jaw axis and which is spaced a distance transversely from an axis defined by each base portion. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with a general description of the invention given above, and the detailed description of the embodiments given below, serve to explain the principles of the invention. 
       FIG. 1  is a perspective view of an endoscopic surgical instrument, in accordance with the present invention; 
       FIG. 2  is a perspective view of the jaw members of the surgical instrument; 
       FIG. 3  is a perspective exploded view of the jaw members shown in  FIG. 2 ; 
       FIG. 4  is a side elevational view of a jaw member as shown in  FIG. 2 ; 
       FIG. 5  is a perspective view of the jaw members shown in  FIG. 2  illustrating the closed position of the jaw members around the proximal end portion of a shaft of an anvil assembly of a circular fastening apparatus; 
       FIG. 6  is a perspective view of the jaw members shown in  FIG. 2  illustrating the jaws in an open position about the proximal end portion of the shaft of the anvil assembly; and 
       FIG. 7  is a side elevational view of the jaw members shown in  FIG. 2  illustrating the closed position of the jaw members about an alternative shaft of an anvil assembly. 
   

   DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
   Preferred embodiments of the presently disclosed surgical jaws for an endoscopic surgical instrument will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. As used herein, the term “distal” refers to that portion which is further from the user, while the term “proximal” refers to that portion which is closer to the user. 
   While the description below will relate to general anastomotic procedures, the present invention can be used in gastric bypass procedures disclosed in commonly assigned International Application Serial No. PCT/US01/07105, Publication No. WO 01/66020, entitled “Apparatus and Method for Performing a Bypass Procedure in a Digestive System”, filed on Mar. 5, 2001, the entire contents of which are herein incorporated by reference. 
   Referring now in detail to  FIGS. 1–7 , an endoscopic surgical instrument in accordance with the present invention is generally designated as reference numeral  100 . Endoscopic instrument  100  includes a pair of surgical jaw members  102  and  104  operatively coupled to a distal end of an enlongate shaft  105  defining a longitudinal axis, which jaw members  102  and  104  move, here pivot, in response to the operation of controls on or remote from a frame, e.g., the opening and closing of a handle assembly  106 . Handle assembly  106  includes a pivoting handle  106 A and a stationary handle  106 B. In use, upon movement of pivoting handle  106 A, an actuation mechanism, here shown as an inner rod  107 , reciprocates in the longitudinal direction indicated by arrow “A” within elongate shaft  105  to operate jaw members  102  and  104 . Such arrangement is appreciated by one skilled in the art. It is envisioned that a proximal end of elongate shaft  105  and a proximal end of inner rod  107  (i.e., the actuation means) can be operatively removably coupled to the distal end of a robotic armature (not shown), wherein the surgical instrument is positioned and maneuvered via a computer control system (not shown) which is connected to the robotic armature. 
   Referring now in detail to  FIGS. 2–4 , each jaw member  102  and  104  respectively includes a base portion  108  and  110  at their proximal end, a gripper portion  112  and  114  at their distal end, and an intermediate body portion  116  and  118  interconnecting base portion  108  and  110  to gripper portion  112  and  114 , respectively. 
   Each base portion  108  and  110  includes a diametric radial hole  120  and  122 , respectively for accepting a pivot pin (not shown) therethrough, which pivot pin is secured to surgical instrument  100 . In operation, gripper portions  112  and  114  of jaw members  102  and  104 , pivot about the pivot pin passing through radial holes  120  and  122  during an opening and a closing operation. Each base portion  108  and  110  is further provided with a cam slot  124  and  126 , respectively, which slots are configured and adapted to receive a bearing post  127  ( FIG. 1 ) therethrough. Preferably, cam slots  124  and  126  are formed proximally of radial holes  120  and  122 , however, it is envisioned that cam slots  124  and  126  can be formed distally of radial holes  120  and  122 . 
   Preferably, bearing post  127  is operatively coupled to handle assembly  106  via the inner rod  107 . In use, as handle assembly  106  is actuated, the bearing post translates proximally and distally. Concomitantly, as handle assembly  106  is actuated, bearing post  127  slides within cam slots  124  and  126  in order to pivot gripper portions  112  and  114  about pivot pin, thereby opening and closing jaw members  102  and  104 . In other words, when handle assembly  106  is actuated closed, the bearing post slides away from jaw members  102  and  104  within cam slots  124  and  126  thereby drawing jaw members  102  and  104  closed. 
   Each intermediate body portion  116  and  118  of jaw members  102  and  104  includes a proximal end portion  128  and  130  extending substantially axially and distally from base portion  108  and  110 , respectively, wherein an axis “A 1 ” of proximal end portions  128  and  130  is in the same plane as an axis “A 2 ” of base portion  108  and  110  (see  FIG. 4 ); and a distal end portion  132  and  134  extending substantially axially from an intermediate neck portion  136  and  138 , respectively, wherein an axis “B 1 ” of distal end portion  132  and  134  is in a plane spaced a distance “X” from axis “A 1 , A 2 ” of base portion  108  and  100 . Intermediate neck portion  136  and  138  interconnects proximal end portions  128  and  130  to distal end portions  132  and  134 . The axis “A 1 , A 2 ” is considered to be the axis of the jaw member, i.e., the jaw axis. 
   Gripper portions  112  and  114  extend distally from the ends of distal end portions  132  and  134  of jaw members  102  and  104 . Each gripper portion  112  and  114  is provided with a recess  140 ,  142 , preferably semi-cylindrical formed on corresponding facing surfaces  143 . When such jaw members are in the closed position, recesses  140 ,  142  form a holding groove “G”. Holding groove “G” extends through the entire thickness of each gripper portion  112  and  114 . Preferably, recesses  140 ,  142 , and holding groove “G” are formed to have a central axis which is orthogonal to the plane of gripper portions  112  and  114 . 
   Preferably, gripper portions  112  and  114  are oriented at an angle “α” that is preferably from about 55° to about 75° relative to the longitudinal axis of elongated shaft  105 , rod  107  or to axis “A 1 ” of proximal end portions  128  and  130 , axis “A 2 ” of base portions  108  and  110  or axis “B 1 ” of distal end portions  132  and  134 . More preferably, angle “α” of the plane of gripper portions  112  and  114  is about 70° relative to axes “A 1 ”, “A 2 ” or “B 1 ”. Most preferably, angle “α” of the plane of gripper portions  112  and  114  is about 65° relative to axes “A 1 ”, “A 2 ” or “B 1 ”. Accordingly, the central axis of recesses  140 ,  142  and of holding groove “G” is at an angle “β” that is preferably from about 15° to about 35°, more preferably about 20° and most preferably about 25° relative to axes “A 1 ”, “A 2 ” or “B 1 ”. 
   It is envisioned that each jaw member  102  and  104  can be provided with a gripper portion  112  and  114 , at least one, preferably each, having one or more recesses  140  and/or  142 , which recess or recesses form(s) a holding groove “G” when the jaw members are in the closed position. Preferably each recess and holding groove has a central axis that is about 35° or less relative to the longitudinal axis of elongate shaft  105 , rod  107  or axis “A 1 ”, “A 2 ” or “B 1 ”. Thus, the central axis of recesses  140 ,  142  and/or of holding groove “G” can be co-axial or co-planar with any one or more of such axes. In this manner, in use, when jaw members  102  and  104  grip a shaft, the axis of the shaft can be substantially co-planar with axes “A 1 ”, “A 2 ” or “B 1 ” thereby resulting in a substantially co-linear arrangement. In other words, the central axis of recesses  140 ,  142  and/or of holding groove “G” can be at an angle “β” which is 0° or parallel to the longitudinal axis of the elongate shaft. 
   Preferably, in use, when jaw members  102  and  104  are in a closed position, holding groove “G” is a substantially circular opening. While a substantially circular opening is preferred, especially for grasping a cylindrical portion of an anvil shaft, it is envisioned that the formed opening can take on any shape, including and not limited to, polygonal, rectangular, triangular, ovular, etc. Preferably, the inner surface of holding grooves  140  and  142  are smooth, however, it is envisioned that the inner surface of holding grooves  140  and  142  can be provided with a textured surface, including but not limited to, knurled, toothed, serrated, etc. The inner surface is designed to allow it to grasp the intended portion, e.g., one or more recesses of or for the anvil shaft. 
     FIGS. 5 and 6  illustrate one example of the use of the invention in accordance with the present disclosure. As discussed above, typical instruments for performing a circular anastomosis of hollow organs include a detachable anvil assembly  200  having a shaft  202  and an attached or detachable anvil head  204 , and/or a staple cartridge or cartridge assembly  212  (see  FIG. 7 ) to provide circular stapling of the intestinal sections. It is to be understood that shaft  202  can be detached from an anvil, or can be a trocar shaft. In order to staple the intestinal sections of a patient to one another, anvil assembly  200  is previously inserted into an intestinal section (not shown) with the aid of an insertion instrument “T”. The open end of the intestinal section is sutured or tied over the anvil head and about an attachment portion of the anvil shaft.  202 . The cartridge assembly  212  (see  FIG. 7 ) is previously inserted into the opposite intestinal section (not shown) whose open end is likewise disposed over and sutured about the distal end of the cartridge assembly. 
   It is envisioned that the sutured portions of the intestine are somewhat diagonally displaced from each other. Shaft  202  may have a recessed grasping portion  206 , with a reduced cross section, near a distal end thereof, which, in accordance with the present invention, in  FIG. 6 , is to be engaged by recesses  140  and  142  of jaw members  102  and  104 . In order to staple the two intestinal sections together, the operating surgeon grasps grasping portion  206  of shaft  202  with holding groove “G” of surgical jaw members  102  and  104  while manually or robotically holding or manipulating the frame or handle  14  of, or the endoscopic instrument  10  itself. The surgeon then pulls shaft  202  toward the cartridge assembly for insertion of tip  208  of shaft  202  into a guiding, receiving and engaging portion or the like (not shown) of the cartridge assembly. 
   It is contemplated that jaw members  102  and  104 , of the present invention, are adapted to engage and surround shaft  202  of anvil assembly  200  at various locations and orientations relative thereto. For example, as seen in  FIG. 7 , it is contemplated that jaw members  102  and  104  grasp shaft  202  at a location above or distally of splines  210 , e.g., at recess “R” (dashed lines), which splines  210  are used to align shaft  202  with the staple firing mechanism  212  (i.e., cartridge assembly) with anvil assembly  200 . In this manner, jaw members  102  and  104  do not interfere with the insertion of shaft  202  into the cartridge assembly  212 . Thus, with this objective in mind, anvil shaft  202  preferably is adapted to be grasped at a location that is sufficiently removed, for example, more than a third, or half or more than half of the length of shaft  202  measured from the proximal end of the shaft. 
   It is further contemplated that the size and overall dimensions of endoscopic surgical instrument  10  are such that instrument  10  can be inserted into the patient via a 15 mm or 10 mm trocar. While an instrument which is insertable through a 15 mm or 10 mm trocar is disclosed, it is envisioned that the instrument can have any size and dimension. 
   The present invention provides substantial benefits to users compared to prior art devices. The jaws of the invention, facilitate grasping and manipulation of an object, such as shaft  202  of anvil assembly  200 , toward and mounting it onto or into a targeted structure. However, it is appreciated that the surgical instrument of the invention may be used with any other elongated surgical instrument. The ease of manipulation provided by the design of the instrument is especially advantageous if there is limited operative space, e.g. if there are certain obstacles limiting the path of movement of the grasping instrument. More specifically, the jaws of the present invention enable the surgeon to approach and grasp the object, e.g., the shaft of or for the anvil, or a trocar, from a substantially longitudinally aligned direction with respect to the surgical instrument that has the jaws. 
   It will be understood that various modifications can be made to the embodiments of the present invention herein described without departing from the spirit of the invention herein. The invention in its broader aspects therefore is not limited to the specific embodiments herein shown and described but departures may be made therefrom within the scope of the accompanying claims without departing from the principles of the invention and without sacrificing its chief advantages.