Patent Publication Number: US-11382686-B2

Title: Surgical forceps

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation application of U.S. patent application Ser. No. 14/805,759, filed on Jul. 22, 2015, the entire contents of which are hereby incorporated herein by reference. 
    
    
     BACKGROUND 
     Technical Field 
     The present disclosure relates to surgical forceps and, more particularly, to an open surgical forceps for grasping, treating, and/or dividing tissue. 
     Background of Related Art 
     A forceps is a plier-like instrument which relies on mechanical action between its jaws to grasp, clamp, and constrict tissue. Electrosurgical forceps utilize both mechanical clamping action and electrical energy to treat tissue, e.g., by heating tissue to coagulate, cauterize, and/or seal tissue. 
     Typically, once tissue is treated, the surgeon has to accurately sever the tissue along the treated portion thereof. Accordingly, many forceps have been designed to incorporate a knife which is deployable to effectively sever tissue after treatment thereof. 
     SUMMARY 
     As used herein, the term “distal” refers to the portion that is being described that is further from a user, while the term “proximal” refers to the portion that is being described that is closer to a user. Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any of the other aspects described herein. 
     In accordance with aspects of the present disclosure, a forceps is provided including first and second shaft members, first and second jaw members, and first and second electrode plates. The first and second shaft members each define a proximal end and a distal end. The first and second jaw members each include a distal jaw body and a proximal flange. The proximal flanges of the first and second jaw members are engaged with the respective first and second shaft members and are pivotably coupled to each other such that pivoting the first and second shaft members relative to each other from an open position to a closed position pivots the distal jaw bodies of the first and second jaw members relative to each other from a spaced-apart position to an approximated position. The first electrode plate is coupled to the first jaw member and includes a tissue-contacting portion disposed on the distal jaw body of the first jaw member and a proximal extension portion extending proximally from the tissue-contacting portion at least partially through the proximal flange of the first jaw member. The tissue-contacting portion and the proximal extension portion are disposed in perpendicular planes relative to each other. The second electrode plate is coupled to the second jaw member and includes a tissue-contacting portion disposed on the distal jaw body of the second jaw member and a proximal extension portion extending proximally from the tissue-contacting portion at least partially through the proximal flange of the second jaw member. The tissue-contacting portion and the proximal extension portion are disposed in perpendicular planes relative to each other. 
     In an aspect of the present disclosure, the proximal extension portion of the first electrode plate extends through the proximal flange of the first jaw member and at least partially through the first shaft member. Additionally or alternatively, the proximal extension portion of the first electrode plate extends about the pivot. 
     In another aspect of the present disclosure, the proximal extension portion of the second electrode plate includes a first segment and a second segment. The first segment extends at least partially through the proximal flange of the second jaw member and is substantially disposed distally of the pivot. The second segment extends at least partially through the proximal flange of the first jaw member and is substantially disposed proximally of the pivot. The second segment extends at least partially through the first shaft member. A spring washer disposed about the pivot may be provided for electrically coupling the first and second segments of the proximal extension portion of the second electrode plate with each other. 
     In yet another aspect of the present disclosure, an activation button disposed on the first shaft member or the second shaft member is provided. In such aspects, the proximal extension portion of at least one of the first or second electrode plates is electrically coupled to the activation button. 
     In still another aspect of the present disclosure, an electrosurgical cable extends from the first shaft member or the second shaft member. In such aspects, the proximal extension portion of at least one of the first or second electrode plates is electrically coupled to the electrosurgical cable. 
     In still yet another aspect of the present disclosure, the first and second shaft members are biased towards the open position thereby biasing the first and second jaw members towards the spaced-apart position. 
     In another aspect of the present disclosure, a knife assembly is operably coupled to one of the first shaft member or the second shaft member and includes a knife blade disposed within one of the first jaw member or the second jaw member. In such aspects, the first and second shaft members are movable from the closed position to a cutting position to move the knife blade from a retracted position to an extended position, wherein the knife blade extends at least partially between the first and second jaw members. 
     In another aspect of the present disclosure, at least one of the tissue-contacting portion of the first electrode plate or the tissue-contacting portion of the second electrode plate defines a knife channel configured to permit passage of the knife blade therethrough. 
     Another forceps provided in accordance with the present disclosure includes first and second shaft members each defining a proximal end and a distal end, first and second jaw members, a knife assembly, an activation button, and an activation assembly. The first and second jaw members are engaged with the respective first and second shaft members and coupled to each other such that moving the first and second shaft members relative to each other from an open position to a closed position moves the first and second jaw members relative to each other from a spaced-apart position to an approximated position. The knife assembly is operably coupled to one of the first shaft member or the second shaft member and includes a knife blade disposed within one of the first jaw member or the second jaw member. The first and second shaft members are movable from the closed position to a cutting position to move the knife blade from a retracted position to an extended position, wherein the knife blade extends at least partially between the first and second jaw members. The activation button is disposed on the first shaft member and configured for selective activation to supply energy to the first and second jaw members. The activation assembly is disposed within the second shaft member and positioned to oppose the activation button. The activation assembly includes a foot movably disposed within a cavity defined within the second shaft member. As such, moving the first and second shaft members relative to each other from the open position to the closed position urges the foot into contact with the activation button to supply energy to the first and second jaw members. Further, moving the first and second shaft members relative to each other from the closed position to the cutting position urges the activation button into contact with the foot such that the foot is recessed into the cavity and at least a portion of the activation button is accommodated within the cavity. 
     In an aspect of the present disclosure, the first and second shaft members are movable relative to each other from the closed position to the cutting position independent of movement of the first and second jaw members. In such aspects, one of the first or second shaft members may be coupled to the respective first or second jaw member via a flexible connection permitting movement of the first and second shaft members relative to each other from the closed position to the cutting position independent of movement of the first and second jaw members. 
     In another aspect of the present disclosure, the knife assembly includes a knife bar engaged with of the first shaft member or the second shaft member. The knife bar is coupled to the knife blade such that movement of the first and second shaft members from the closed position to the cutting position moves the knife blade relative to the first and second jaw members from the retracted position to the extended position. 
     In still another aspect of the present disclosure, the first and second shaft members are biased towards the open position thereby biasing the first and second jaw members towards the spaced-apart position. 
     In yet another aspect of the present disclosure, the foot is coupled to the second shaft member via a biasing member that biases the foot outwardly from the cavity. 
     In still yet another aspect of the present disclosure, the biasing member defines a biasing force that is greater than a force required to activate the activation button. 
     In another aspect of the present disclosure, a first electrode plate is coupled to the first jaw member. The first electrode plate includes a tissue-contacting portion disposed on the first jaw member and a proximal extension portion extending proximally from the tissue-contacting portion at least partially through the first shaft member. 
     In another aspect of the present disclosure, a second electrode plate is coupled to the second jaw member. The second electrode plate includes a tissue-contacting portion disposed on the second jaw member and a proximal extension portion extending proximally from the tissue-contacting portion at least partially through the first shaft member. 
     In yet another aspect of the present disclosure, the proximal extension portion of the second electrode plate includes a first segment and a second segment. The first segment extends at least partially through the second jaw member and the second segment extending at least partially through the first jaw member and at least partially through the first shaft member. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various aspects and features of the present disclosure are described herein with reference to the drawings wherein: 
         FIG. 1  is a side, perspective view of a forceps provided in accordance with the present disclosure; 
         FIG. 2  is a side, perspective view of the forceps of  FIG. 1  including handles disposed thereon; 
         FIG. 3  is an enlarged, side, perspective view of the area of detail indicated as “3” in  FIG. 1 ; 
         FIG. 4  is a top, cross-sectional view of the distal end of the forceps of  FIG. 1 ; 
         FIG. 5A  is a top view of the electrode of one of the jaw members of the forceps of  FIG. 1 ; 
         FIG. 5B  is a top view of the electrode of the other jaw member of the forceps of  FIG. 1 ; 
         FIG. 6  is a top view of one of the shaft members of the forceps of  FIG. 1  with a portion thereof removed to illustrate the internal components thereof; 
         FIG. 7A  is a side view of a portion of the actuation assembly and shaft members of the forceps of  FIG. 1 , disposed in an activated or closed position; 
         FIG. 7B  is a side view of the distal end of the forceps of  FIG. 1 , disposed in the activated or closed position; 
         FIG. 8A  is a side view of a portion of the actuation assembly and shaft members of the forceps of  FIG. 1 , disposed in a cutting position; and 
         FIG. 8B  is a side view of the distal end of the forceps of  FIG. 1 , disposed in the cutting position. 
     
    
    
     DETAILED DESCRIPTION 
     Referring to  FIG. 1 , a forceps  10  provided in accordance with the present disclosure is shown including first and second shaft members  12   a ,  12   b  each having a distal end  14   a ,  14   b  and a proximal end  16   a ,  16   b , respectively. An end effector assembly  100  is disposed at the distal ends  14   a ,  14   b  of shaft members  12   a ,  12   b . End effector assembly  100  includes first and second jaw members  110 ,  120 , each including a distal jaw body  111 ,  121  and a proximal flange  112 ,  122  coupled to a respective one of the first and second shaft members  12   a ,  12   b . The respective distal jaw bodies  111 ,  121  and proximal flanges  112 ,  122  of jaw members  110 ,  120  may be integrally formed with one another and shaft members  12   a ,  12   b , respectively, e.g., via molding, and are formed from an electrically-insulative material, e.g., plastic. One of the shaft members, e.g., shaft member  12   b , is coupled to its respective proximal flange  122  via a flexible connection  13   b , e.g., a living hinge, the importance of which is detailed below. 
     A pivot pin  150  pivotably couples proximal flanges  112 ,  122  of jaw members  110 ,  120  with one another. Thus, with pivot pin  150  extending through proximal flanges  112 ,  122  and being disposed between the respective shaft members  12   a ,  12   b  and the respective jaw members  110 ,  120 , shaft members  12   a ,  12   b  may be moved relative to one another about pivot pin  150  between an open position ( FIG. 1 ) and an activated or closed position ( FIGS. 7A and 7B ) to effect movement of jaw members  110 ,  120  relative to one another about pivot pin  150  between a spaced-apart position ( FIG. 1 ) and an approximated position ( FIG. 7B ), respectively, for grasping tissue therebetween. As detailed below, shaft members  12   a ,  12   b  are further movable towards one another, independent of movement of jaw members  110 ,  120 , from the activated or closed position ( FIG. 7A ) to a cutting position ( FIG. 8A ) via flexion of flexible connection  13   b  for cutting treated tissue grasped between jaw members  110 ,  120 . 
     With momentary reference to  FIG. 3 , each shaft member  12   a ,  12   b  includes a flat spring  21   a ,  21   b , or other suitable biasing member, engaged thereto at a first end  22   a ,  22   b  of the respective flat spring  21   a ,  21   b . Second ends  23   a ,  23   b  of flat springs  21   a ,  21   b  define complementary engagement features, e.g., a tab  24   a  and slot  24   b , so as to enable engagement of second ends  23   a ,  23   b  of flat springs  21   a ,  21   b  with one another. As a result of this configuration and with flat springs  21   a ,  21   b  biased to resist flexion, shaft members  12   a ,  12   b  are biased apart from one another towards the open position ( FIG. 1 ), thereby biasing jaw members  110 ,  120  towards the spaced-apart position ( FIG. 1 ). 
     Referring briefly to  FIG. 2 , each shaft member  12   a ,  12   b  may include a handle  17   a ,  17   b  releasably engagable with the proximal end  16   a ,  16   b  thereof. Each handle  17   a ,  17   b  defines a finger hole  18   a ,  18   b  therethrough for receiving a finger of the user. As can be appreciated, finger holes  18   a  and  18   b  facilitate movement of shaft members  12   a  and  12   b  relative to one another. Handles  17   a ,  17   b  may be formed from first and second components configured to releasably engage one another about shaft members  12   a ,  12   b , e.g., in snap-fit engagement, may define lumens configured to receive the proximal ends  16   a ,  16   b  of shaft members  12   a ,  12   b , respectively, or may be releasably or fixedly engaged with shaft members  12   a ,  12   b  in any other suitable fashion. 
     Returning to  FIG. 1 , one of the shaft members, e.g., shaft member  12   a , is configured to operably couple with an electrosurgical cable  200  at the proximal end  16   a  of shaft member  12   a . Electrosurgical cable  200  is configured to couple to a source of electrosurgical energy such as an electrosurgical generator (not shown). Electrosurgical cable  200  may be permanently secured to proximal end  16   a  of shaft member  12   a  or may be releasably engagable therewith. Electrosurgical cable  200  houses one or more wires (not shown) that extend therethrough. The wires (not shown) are configured to couple to electrode plates  114 ,  124  ( FIG. 6 ) to supply electrosurgical energy to jaw members  110 ,  120 . Shaft member  12   a  further includes an activation button  90  supported thereon and positioned to oppose shaft member  12   b . Activation button  90  is electrically coupled with either or both of electrode plates  114 ,  124  ( FIG. 6 ), as detailed below, to enable the selective supply of energy to jaw members  110 ,  120 . The other shaft member, e.g., shaft member  12   b , includes a knife assembly  80  ( FIGS. 7A-8B ) disposed therein and an actuation assembly  92  ( FIGS. 7A and 8A ) operably coupled thereto for enabling deployment of knife blade  84  of knife assembly  80  (see  FIG. 8B ) and the selective actuation of activation button  90 , respectively, as will also be detailed below. 
     With reference to  FIGS. 1 and 4-6 , each jaw member  110 ,  120  of end effector assembly  100  includes an electrically-conductive electrode plate  114 ,  124  associated therewith. Electrode plates  114 ,  124  each include a tissue-contacting portion  115   a ,  115   b  disposed in a first plane, and a proximal extension portion  115   b ,  125   b  disposed in a second plane or multiple second planes disposed in perpendicular orientation relative to the first plane. Tissue-contacting portions  115   a ,  125   a  and proximal extension portions  115   b ,  125   b  of electrode plates  114 ,  124 , respectively, are monolithically formed with one another, e.g., each electrode plate  114 ,  124  is formed from a single sheet of material. Thus, in order to achieve the perpendicular orientation of tissue-contacting portions  115   a ,  125   a  relative to respective proximal extension portions  115   b ,  125   b , electrode plates  114 ,  124  define twisted sections  116 ,  126  interconnecting respective tissue-contacting portions  115   a ,  125   a  and respective proximal extension portions  115   b ,  125   b . Either or both of tissue-contacting portions  115   a ,  125   a  of electrode plates  114 ,  124  may further define a longitudinally-extending knife channel  118 ,  128  defined therethrough. 
     Jaw members  110 ,  120  each include, as mentioned above, a distal jaw body  111 ,  121  and a proximal flange  112 ,  122 . Tissue-contacting portions  115   a ,  125   a  of electrode plates  114 ,  124 , respectively, are disposed on respective distal jaw bodies  111 ,  121  of jaw members  110 ,  120  in opposing relation relative to one another such that, upon movement of jaw members  110 ,  120  from the spaced-apart position to the approximated position, tissue can be grasped between tissue-contacting portions  115   a ,  125   a  of electrode plates  114 ,  124 . As detailed below, with tissue grasped between tissue-contacting portions  115   a ,  125   a  of electrode plates  114 ,  124 , electrode plates  114 ,  124  may be energized to conduct energy through tissue grasped therebetween to treat tissue. 
     Proximal extension portions  115   b ,  125   b  of electrode plates  114 ,  124  extend proximally from respective tissue-contacting portions  115   a ,  125   a  and distal jaw bodies  111 ,  121 , and at least partially through proximal flanges  112 ,  122  of jaw members  110 ,  120 , respectively. More specifically, proximal extension portion  115   b  of electrode plate  114  of jaw member  110  extends through proximal flange  112 , about pivot pin  150 , and proximally through shaft member  12   a , ultimately coupling to activation button  90  and one or more of the wires (not shown) of electrosurgical cable  200  (see  FIG. 6 ). To permit routing about pivot pin  150 , proximal extension portion  115   b  of electrode plate  114  may include an aperture or slot (not shown) configured to receive pivot pin  150  therethrough, although other configurations are also contemplated. 
     Proximal extension portion  125   b  of electrode plate  124 , which extends proximally from distal jaw body  121  into proximal flange  122  of jaw member  120  defines an interruption dividing proximal extension portion  125   b  into first and second segments  129   a ,  129   b . First segment  129   a  of proximal extension portion  125   b  is substantially disposed distally of pivot pin  150  (although a small portion, e.g., less than 10% of its length, extends proximally beyond pivot pin  150 ), while second segment  129   b  of proximal extension portions  125   b  is substantially disposed proximally of pivot pin  150  (although a small portion, e.g., less than 10% of its length, extends distally beyond pivot pin  150 ). 
     The above-noted interrupted configuration of proximal extension portion  125   b  of electrode plate  124  allows first segment  129   a  of proximal extension portion  125   b  to extend through proximal flange  122  of jaw member  120 , while second segment  129   b  of proximal extension portion  125   b  extends through proximal flange  112  of jaw member  110 , and proximally through shaft member  12   a , ultimately coupling to activation button  90  and one or more of the wires (not shown) of electrosurgical cable  200  (see  FIG. 6 ). A spring washer  129   c  disposed about pivot pin  150  is provided for maintaining electrical communication between first and second segments  129   a ,  129   b  of proximal extension portion  125   b  of electrode plate  124  regardless of the positioning of shaft members  12   a ,  12   b  relative to one another about pivot pin  150 . First and second segments  129   a ,  129   b , respectively, may define slots or apertures (not shown) to permit passage about pivot pin  150 , similarly as detailed above with respect to electrode plate  114 , although other configurations are also contemplated. 
     Referring in particular to  FIG. 6 , as detailed above, proximal extension portion  115   b  of electrode plate  114  and second segment  129   b  of proximal extension portion  125   b  of electrode plate  124  extend through shaft member  12   a , ultimately coupling to activation button  90  and one or more of the wires (not shown) of electrosurgical cable  200 . Further, with shaft member  12   a  (as well as shaft member  12   b  ( FIG. 1 )) formed from an electrically-insulative material, a user is protected from contacting electrode plates  114 ,  124  while grasping shaft member  12   a.    
     Turning now to  FIGS. 1 and 7A-8B , shaft member  12   b , as noted above, includes a knife assembly  80 . Knife assembly  80  includes a knife bar  82  and a knife blade  84 . Knife bar  82  is fixedly engaged within shaft member  12   b  at the proximal end of knife bar  82  and extends distally through shaft member  12   b  and proximal flange portion  122  ( FIG. 1 ) of jaw member  120 . Knife bar  82  defines an aperture  83  configured to receive pivot pin  150  to permit passage of knife bar  82  about pivot pin  150  and enable pivoting of knife bar  82  relative to pivot pin  150 . Knife blade  84  extends distally from knife bar  82  and, in a retracted position thereof, is housed within distal jaw body  121  of jaw member  120  ( FIG. 7B ). Knife blade  84  defines a sharpened upper cutting surface  85  and is pivotable about pivot pin  150  and relative to jaw members  110 ,  120  from the retracted position ( FIG. 7B ) to an extended position ( FIG. 8B ), wherein knife blade  84  extends at least partially from knife channel  128  ( FIG. 5B ) of jaw member  120  between tissue-contacting portions  115   a ,  125   a  of electrode plates  114 ,  124  to cut tissue grasped therebetween. In the extended position, knife blade  84  may further extend at least partially through knife channel  118  ( FIG. 5A ) of jaw member  110 , in embodiments where such a channel is provided. 
     Knife blade  84  is moved from the retracted position ( FIG. 7B ) to the extended position ( FIG. 8B ) in response to movement of shaft members  12   a ,  12   b , independent of movement of jaw members  110 ,  120 , from the activated or closed position ( FIG. 7A ) to a cutting position ( FIG. 8A ). Such movement of shaft members  12   a ,  12   b  is enabled via flexion of flexible connection  13   b , which permits flexion of shaft member  12   b  relative to jaw member  120 . More specifically, with knife bar  82  fixedly engaged within shaft member  12   b , as shaft member  12  is flexed relative to jaw member  120  via flexion of flexible connection  13   b , knife bar  82  and, thus, knife blade  84  are likewise moved relative to jaw member  120 . Upon sufficient flexion of shaft member  12   b  relative to jaw member  120 , knife blade  84  is moved from the retracted position ( FIG. 7B ) to the extended position ( FIG. 8B ). Flexible connection  13   b  is biased so as to normally align shaft member  12   b  with jaw member  120  in generally linear longitudinal alignment, thus biasing knife blade  84  towards the retracted position ( FIG. 7B ). 
     With continued reference to  FIGS. 7A-8B , as also noted above, shaft member  12   b  includes an actuation assembly  92  operably coupled thereto for enabling the selective actuation of activation button  90 . Actuation assembly  92  is further configured to accommodates activation button  90  upon deployment of knife blade  84  of knife assembly  80 , thus inhibiting damage to activation button  90  when shaft members  12   a ,  12   b  are moved to the cutting position. More specifically, actuation assembly  92  is disposed within a cavity  94  defined within shaft member  12   b  and is positioned to oppose activation button  90  of shaft member  12   a . Actuation assembly  92  includes a foot  95  disposed within cavity  94 . Foot  95  is coupled to shaft member  12   b  via a biasing member  96 , e.g., a coil spring, biased such that foot  95  is substantially flush with the surface of shaft member  12   b , although other configurations are also contemplated. 
     With particular reference to  FIGS. 7A and 7B , biasing member  96  defines a biasing force that is greater than the force required to activate activation button  90  such that, upon movement of shaft members  12   a ,  12   b  from the open position to the activated or closed position to move jaw members  110 ,  120  to the approximated position for grasping tissue therebetween, foot  95  is urged into contact with activation button  90  and activates activation button  90  while being maintained in substantially flush position relative to the surface of shaft member  12   b . In the activated or closed position of activation button  90 , the supply of energy to tissue-contacting portions  115   a ,  125   a  of electrode plates  114 ,  124  of jaw members  110 ,  120  is initiated. More specifically, tissue-contacting portions  115   a ,  125   a  of electrode plates  114 ,  124  of jaw members  110 ,  120  are energized to different potentials such that an electrical potential gradient is created therebetween, allowing for the conduction of energy through tissue grasped between jaw members  110 ,  120  to treat tissue. 
     With particular reference to  FIGS. 8A and 8B , the biasing force of biasing member  96  is less than the force required to flex flexible connection  13   b  such that, upon further urging of shaft members  12   a ,  12   b  from the activated or closed position to the cutting position, foot  95  is recessed into cavity  94  via the activation button  90  and against the bias of biasing member  96 , thus permitting movement of shaft member  12   a ,  12   b  to the cutting position while cavity  94  accommodates activation button  90  therein. As detailed above, upon movement of shaft members  12   a ,  12   b  to the cutting position, knife blade  84  of knife assembly  180  is moved to the extended position, wherein knife blade  84  extends at least partially through knife channel  128  of jaw member  120  (and, in some embodiments, into knife channel  118  of jaw member  110 ) to cut tissue grasped between jaw members  110 ,  120 . 
     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&#39;s ability to mimic actual operating conditions. 
     From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.