Abstract:
The present invention is a device having a rigidly linked jaw that is decoupled from an articulating wrist. The device provides for articulating motion as well as actuation that may be used in grasping, cutting, suturing or the like.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 13/633,963, filed Oct. 3, 2012, now U.S. Pat. No. 8,845,681, which is a continuation of U.S. patent application Ser. No. 11/948,052, filed Nov. 30, 2007, now U.S. Pat. No. 8,292,916, which is a division of U.S. patent application Ser. No. 10/013,170, filed Jun. 7, 2002, now U.S. Pat. No. RE43049, which is a continuation-in-part of application Ser. No. 09/262,134, filed Mar. 3, 1999, now U.S. Pat. No. 6,436,107, which is a continuation-in-part of application Ser. No. 08/873,190, filed Jun. 11, 1997, now U.S. Pat. No. 6,102,850, which is a continuation-in-part of application Ser. No. 08/755,063, filed Nov. 22, 1996, now U.S. Pat. No. 5,855,583. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention generally relates to surgical devices. More particularly, the present invention relates to a device for suturing during the performance of minimally invasive endoscopic surgical procedures and more particularly to an articulating device for use in endoscopic coronary artery by-pass grafting surgery. 
     2. Description of Related Art 
     Blockage of a coronary artery may deprive the heart of the blood and oxygen required to sustain life. The blockage may be removed with medication or by an angioplasty. For severe blockage, a coronary artery bypass graft (CABG) is performed to bypass the blocked area of the artery. CABG procedures are typically performed by splitting the sternum and pulling open the chest cavity to provide access to the heart. An incision may be made in the artery adjacent to the blocked area. The internal mammary artery (IMA) or some other arterial source of blood-flow may then be severed and attached to the artery at the point of incision. The IMA bypasses the blocked area of the artery to again provide a full flow of blood to the heart. 
     Splitting the sternum and opening the chest cavity can create tremendous trauma on the patient. Additionally, the cracked sternum prolongs the recovery period of the patient. As such, there have been developed systems that enable minimally invasive CABG procedures. These systems utilize hand held tools and small incisions, on the order of 3-5 inches in length, to provide access to the thoracic region of a patient. 
     Such minimally invasive procedures are conducted by inserting surgical instruments through small incisions, on the order of inches in the skin of the patient. Manipulating such instruments can be awkward, particularly when suturing a graft to an artery. These systems utilize direct visualization of the surgical site. Such systems do not enable a completely endoscopic approach to the CABG procedure because of the need for direct visualization of the site. Additionally, such systems do not enable a fully endoscopic approach because of the incision size necessary to adequately manipulate the surgical instruments at the surgical site. 
     A fully endoscopic approach utilizes small holes to provide access to the thoracic cavity. Each of these holes is on the order of 3-11 mm in diameter. In order to perform a CABG procedure in a fully endoscopic fashion (i.e. using 3-11 mm holes) a robotic system must be used to filter hand tremors and scale motions made by the surgeon. 
     To facilitate the performance of an endoscopic surgical procedure, it would be useful to employ surgical instruments that can maneuver to the surgical site as well as manipulate tissue or sutures to perform an anastomosis. 
     To help minimize risk to the patient, and to minimize operating time, what is needed in the art is a robotically actuated surgical device that can articulate as well as actuate without being overly complex in design. 
     SUMMARY OF THE INVENTION 
     The present invention is an articulating device for tissue and needle manipulation, the device comprising: 
     An elongated housing having a proximal end and a distal end; 
     an articulation rod extending interior the housing, the articulation rod having a proximal end and a distal end; 
     an actuation rod extending interior the housing, the actuation rod having a proximal end and a distal end; 
     a rack driver in communication with the actuation rod at the distal end thereof, the rack driver engaged with a cylindrical rack for translating the motion of the actuation rod substantially about ninety degrees; and 
     a jaw in communication with the cylindrical rack, whereby movement of the cylindrical rack actuates the jaw, the jaw further in pivotal communication with the articulation rod such that linear movement of the articulation rod produces rotational movement of the jaw. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a partial break-away perspective view of a device in accordance with the present invention in a closed angled configuration; 
         FIG. 2  is a partial break-away perspective view of a device in accordance with the present invention in an open angled configuration; 
         FIG. 3  is a cross-sectional perspective view of a device in accordance with the present invention in an opened straight configuration; 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Referring to the drawings more particularly by reference numbers,  FIGS. 1, 2 and 3  show a preferred embodiment of the articulating actuating device  10 . The device  10  includes a housing  12 . The housing extends substantially the length of the instrument  10  and has a proximal end  14  and a distal end  16  and a longitudinal axis X. Disposed interiorly the housing  12  is an articulation rod  20  and an actuation rod  30 . Each of the articulation rod  20  and the actuation rod  30  have respective proximal ends  22 ,  32  and distal ends  24 ,  34 . 
     The proximal ends  22 ,  32  of the rods may be attached to a robotic system for the performance of minimally invasive surgical procedures. One such system is produced by Computer Motion, Inc. The assignee hereof and is described in U.S. Pat. No. 5,855,583, which is incorporated herein by reference. 
     The rods  20 ,  30  are attached to actuators via attachment means taught in U.S. Pat. No. 5,855,583. Other means for removably attaching a rod to an actuator are known in the art including the use of screws, clips or the like. In this way, each of the rods  20 ,  30  may be driven by the actuator which is connected to various user interfaces and power sources and are conducive to the performance of minimally invasive surgical procedures. 
     The articulation rod  20  extends substantially the length of the housing  12  along its longitudinal axis X. The articulation rod  20  is pivotally connected to a jaw  50 . Such a pivotal connection may be accomplished through the use of a hinge  52  attached intermediate the articulation rod  20  and the jaw  50 . 
     The jaw  50  pivotally communicates with the housing  12  at the distal end  16  thereof through the use of a rack  60 . In this way, motion of the articulation rod  20  results in rotation of the jaw  50 . The rack  60  provides a pivot about which the jaw  50  rotates. 
     The actuation rod  30  provides for actuation of the jaw  50 . The actuation rod has a pin  36  disposed at the distal end  34  thereof. The pin  36  seats in a rack channel  72  disposed in a rack driver  70 . The rack driver is pivotally attached to the housing  12  via a pin  74  or the like. The housing has two longitudinal apertures  18 ,  19  formed therethrough at the distal end  16  thereof to provide for lateral movement of the rack driver  70  which shall be described in detail hereinbelow. 
     Longitudinal motion of the actuation rod  30  moves the pin  36  in the rack channel  72  which translates the longitudinal motion of the actuation rod  30  into a pivotal motion of the rack driver  70 . The rack driver  70  pivots about the pivot point defined by the pin  74  which attaches the rack driver  70  to the housing  12 . The rack driver  70  may move outside of the space defined as the interior of the housing through the longitudinal apertures  18 ,  19 . 
     The rack driver  70  has a shoulder  76  which engages the rack  60 . As the rack driver  70  pivots, the shoulder  76  causes the rack  60  to move laterally, which is orthogonal to the longitudinal motion of the actuation rod  30  and orthogonal to the longitudinal axis of the housing  12 . The rack  60  is slidably moveable within the housing  12  through two cylindrical apertures  13 ,  15  formed therethrough. As the rack  60  moves laterally, the jaw  50  is actuated. The lateral movement of the rack  60  is transferred to a first jaw element  54 . A second jaw element  56  is pivotally connected to the first jaw element  54  via a pin  58  or the like and is held stationary with respect to the first jaw element  54 . In this way, as the first jaw element is  54  is moved, the second jaw element  56  remains stationary and the jaw  50  is actuated. If each element has a sharp edge, then the jaw may function as a scissors. 
     The jaw  50  is always in communication with the rack  60 , even as it is articulated through the motion of the articulation rod  20 . This is accomplished through the use of a cylindrical rack having a circumferential channel  66  formed therein. The channel  66  receives the shoulder  76  of the rack driver  70  as well as a shoulder  58  on the first jaw element  54 . As such, as the jaw  50  is articulated, the shoulder  58  on the first jaw element  54  rotates within the circumferential channel  66  in the rack  60  maintaining communication therein and providing for actuation of the jaw  50  regardless of the articulated position of the jaw  50  caused through motion of the articulation rod  20 . 
     In this fashion, the articulation of the jaw  50  and the actuation of the jaw  50  are decoupled. It is highly advantageous to provide for a rigidly linked device that is decoupled in this fashion for several reasons. First, the device is easily steralizable and secondly, the device is quite safe to use as there is no use of tensioned cables or the like. 
     While certain exemplary embodiments have been described and shown in the accompanying drawings, it is to be understood that such embodiments are merely illustrative of and not restrictive on the broad invention, and that this invention not be limited to the specific constructions and arrangements shown and described, since various other modifications may occur to those ordinarily skilled in the art.