Source: https://patents.google.com/patent/US20130105545A1/en
Timestamp: 2019-10-23 16:09:20
Document Index: 276477108

Matched Legal Cases: ['Application No. 61', 'art 22', 'art 54', 'art 56', 'art 24', 'art 56', 'art 56', 'art 54', 'art 56', 'art 54', 'art 56', 'art 56']

US20130105545A1 - Surgical Instrument with Integral Knife Blade - Google Patents
Surgical Instrument with Integral Knife Blade Download PDF
US20130105545A1
US20130105545A1 US13/662,376 US201213662376A US2013105545A1 US 20130105545 A1 US20130105545 A1 US 20130105545A1 US 201213662376 A US201213662376 A US 201213662376A US 2013105545 A1 US2013105545 A1 US 2013105545A1
US13/662,376
US9924941B2 (en
2011-10-26 Priority to US201161551876P priority Critical
2012-10-26 Priority to US13/662,376 priority patent/US9924941B2/en
2013-01-04 Assigned to Intuitive Surgical Operations, Inc. reassignment Intuitive Surgical Operations, Inc. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BURBANK, WILLIAM A.
2013-05-02 Publication of US20130105545A1 publication Critical patent/US20130105545A1/en
2018-03-27 Publication of US9924941B2 publication Critical patent/US9924941B2/en
This application claims the benefit of U.S. Provisional Application No. 61/551,876, filed Oct. 26, 2011, the entirety of which is incorporated by reference herein.
Improved surgical clamping and cutting instruments (e.g., surgical staplers, and electrosurgical vessel sealing devices) and related methods are disclosed. Surgical clamping and cutting instruments described herein employ a proximal to distal knife movement, thereby orienting the knife to greatly reduce the likelihood of unintentionally cutting tissue while removing the surgical instrument from the surgical site in the event that the surgical instrument fails to fully actuate. Surgical clamping and cutting instruments described herein locate the knife and associated drive mechanism distal to the wrist of the surgical instrument, thereby permitting the use of a high motion wrist to provide high maneuverability. And surgical clamping and cutting instruments described herein employ relative movement between the drive mechanism and the knife, thereby reducing the length of the surgical instrument.
Thus, in one aspect, a method of articulating a cutting blade in a surgical instrument is disclosed. The method includes supporting a knife member having a cutting blade within a housing of the surgical instrument. The housing has a proximal end and a distal end. The cutting blade is configured to cut when the knife member is moved distally. A drive member is moved distally through a first movement from a first position to a second position. The knife member is coupled with the housing during the first movement of the drive member, thereby restraining the knife member from moving distally. The drive member is used to drive the knife member distally during a second distal movement of the drive member from the second position to a third position.
The knife member can be restrained from moving distally throughout a movement of the drive member distally. For example, the knife member can be restrained from moving distally throughout an approximate 4 mm movement of the drive member distally.
In many embodiments, the act of coupling the knife member with the housing includes using the drive member to secure engagement between the knife member and the housing. For example, the drive member can be interfaced with the knife member to secure engagement between the knife member and the housing. In many embodiments, the knife member includes a first protrusion that interfaces with the drive member and a receptacle of the housing to restrain the knife member during the first movement of the drive member from moving distally. The knife member can be rotated to remove the first protrusion from the housing receptacle. The first protrusion can be received within a receptacle of the drive member. And the first protrusion can be accommodated in the drive member receptacle during the second movement of the drive member.
In many embodiments, the knife member includes a drive feature that does not interface with the drive member during the first movement of the drive member and interfaces with the drive member during the second movement of the drive member. In many embodiments, the knife drive feature includes a second protrusion.
In many embodiments, the knife member is rotated near the end of the actuation stroke to lower the cutting blade into the housing. For example, the knife member can be driven along a cam surface thereby raising a distal end of the knife member and lowering the cutting blade into the housing.
In many embodiments, the drive member is used to provide additional functionality. For example, the method can include using the drive member to deploy staples during the second movement of the drive member.
In another aspect, a surgical instrument is disclosed. The surgical instrument includes an elongated shaft having a shaft distal end and a shaft proximal end, an end effector coupled to the shaft distal end and including opposed jaws, a housing included in one of the jaws, a knife member, and a drive member. The housing includes a housing proximal end, a housing distal end, an upper surface extending between the housing proximal and distal ends, a central cavity extending between the housing proximal and distal ends, and a longitudinal slot extending through the upper surface. The knife member is supported within the housing for movement distally. The knife member has a cutting blade configured to cut when the knife member is moved distally. The drive member is slidably mounted in the housing for movement distally. The knife member is coupled with the housing during a first movement of the drive member distally from a first position to a second position to restrain the knife from moving distally. The knife member is driven distally by the drive member during a second movement of the drive member distally from the second position to a third position.
The knife member of the surgical instrument can be restrained from moving distally through the first movement of the drive member distally. For example, the knife member can be restrained from moving distally throughout an approximate 4 mm movement of the drive member distally.
In many embodiments, the drive member is used to secure engagement between the knife member and the housing during the first movement of the drive member to restrain the knife member from moving distally. For example, the drive member can be interfaced with the knife member to secure engagement between the knife member and the housing. In many embodiments, the knife member includes a first protrusion that interfaces with the drive member and a receptacle of the housing to restrain the knife member during the first movement of the drive member from moving distally. The knife member can be rotated to remove the first protrusion from the housing receptacle. The first protrusion can be received within a receptacle of the drive member. And the first protrusion can be accommodated in the drive member receptacle during the second movement of the drive member.
In many embodiments, the knife member is rotated near the end of the actuation stroke to lower the cutting blade into the housing. For example, the housing can include a cam surface configured to interface with the knife member to raise a distal end of the knife member to lower the cutting blade into the housing as the drive member is moved distally through a third movement from the third position to a fourth position.
In many embodiments, the surgical instrument is configured to perform an additional function. For example, the housing can include a plurality of staple openings extending between the upper surface and the central cavity. The surgical instrument can further include a plurality of staples disposed in the staple openings. Each of the staples can be deployed in response to a movement of the drive member distally.
In another aspect, a demountably attachable cartridge of a surgical instrument is disclosed. The cartridge includes a housing demountably attachable to an end effector of the surgical instrument, a lead screw coupled with the housing for rotation relative to the housing, a rotary input rotationally coupled with the lead screw, a knife member, and a drive member mounted in the housing and coupled with the lead screw for movement along the lead screw in response to rotation of the lead screw. The housing includes a proximal end, a distal end, an upper surface extending between the proximal and distal ends, a central cavity between the housing proximal and distal ends, and a longitudinal slot extending through the upper surface. The rotary input is configured to couple with a rotary output of the surgical instrument when the housing is attached to the end effector. The knife member is supported within the housing for movement distally. The knife member is coupled with the housing during a first movement of the drive member distally from a first position to a second position to restrain the knife from moving distally. The knife member is driven distally by the drive member during a second movement of the drive member distally from the second position to a third position.
In many embodiments, the cartridge is configured to perform an additional function. For example, the housing can include a plurality of staple openings extending between the upper surface and the central cavity. The cartridge can further include a plurality of staples disposed in the staple openings. Each of the staples can be deployed in response to a movement of the drive member distally.
FIG. 18 lists optional acts of the method of FIG. 17.
FIG. 4 diagrammatically illustrates a robotic surgery system 50 (such as MIRS system 10 of FIG. 1). As discussed above, a Surgeon's Console 52 (such as Surgeon's Console 16 in FIG. 1) can be used by a Surgeon to control a Patient Side Cart (Surgical Robot) 54 (such as Patent Side Cart 22 in FIG. 1) during a minimally invasive procedure. The Patient Side Cart 54 can use an imaging device, such as a stereoscopic endoscope, to capture images of the procedure site and output the captured images to an Electronics Cart 56 (such as the Electronics Cart 24 in FIG. 1). As discussed above, the Electronics Cart 56 can process the captured images in a variety of ways prior to any subsequent display. For example, the Electronics Cart 56 can overlay the captured images with a virtual control interface prior to displaying the combined images to the Surgeon via the Surgeon's Console 52. The Patient Side Cart 54 can output the captured images for processing outside the Electronics Cart 56. For example, the Patient Side Cart 54 can output the captured images to a processor 58, which can be used to process the captured images. The images can also be processed by a combination the Electronics Cart 56 and the processor 58, which can be coupled together to process the captured images jointly, sequentially, and/or combinations thereof One or more separate displays 60 can also be coupled with the processor 58 and/or the Electronics Cart 56 for local and/or remote display of images, such as images of the procedure site, or other related images.
FIGS. 13A through 13C shows staple deployment related components of a linear stapling and cutting surgical instrument having four rows of staples, in accordance with many embodiments. Similar to the cartridge 100, an internally-threaded drive member 144-4 is coupled with a lead screw 134 and slidably mounted in a cartridge body (not shown) for translation along the lead screw 134 in response to rotation of the lead screw 134. The drive member 144-4 includes distally facing bi-linear ramps 176-4, which engage staple pushers 160-4 as the drive member 144-4 is advanced distally along the lead screw 134. Each of the staple pushers 160-4 is configured to push a single staple (not shown). Each of the staple pushers 160-4 has bi-linear ramp surfaces 186-6, which are configured to interface with the correspondingly sloped bi-linear ramps 176-4 of the drive member 144-4. Each of the staple pushers 160-4 has end portions 188-4 that are shaped to slidingly interface with staple openings in the cartridge body.
FIGS. 15A through 15C provide additional illustration of the knife member 146. In many embodiments, the cutting blade 178 is formed integral to the knife member body portion 180. The proximal protrusions 168 and the distal protrusions 170 can be integral with the knife member body portion 180, or Ruined by press-fitting pins into transverse holes in the knife-member body portion 180. The body portion 180 and the pins can be formed from a suitable material(s), for example, 17-4 PH, 440A, or 420 stainless steels. The cutting blade 178 is beveled to a ground edge on both sides, but can be flat with a ground edge, or beveled only on one side while ground on the other. Additional honing can be performed to create multiple angles on each side of the cutting blade 178.
The configuration of the knife member 146 provides robust support of the cutting blade 178, which may be particularly advantageous when the cutting blade 178 is used to cut through something other than soft tissue. For example, it may occur that the cartridge 100 is used to install staples through previously stapled tissue, thereby possibly placing an existing staple in the path of the cutting blade 178 so that the existing staple must be cut by the cutting blade 178.
FIG. 15H illustrates another alternative configuration of the knife member 146. Here, the knife member 146 is formed with integral pins 187 extending laterally on one side. The pins 187 respectively provide male coupling surfaces for attaching the knife member 146 to other portions of the cartridge 100 in a similar manor to pins 168 and 170 of FIG. 15C. The pins 187 can be formed, for example, by: stamping a singular piece of source material to form the knife member 146 integrally with the pins 187; welding/pressing/bonding the pins 187 into a separate knife member 146; or by molding (with additional forging as needed) the knife member 146 integrally with the pins 187. The pins 187 can also extend from both sides of the knife member 146, on the side opposite as shown, or the pins can extend from each side of the knife member 146 at different or the same proximal and distal portions of the knife member 146. Indented surfaces 189 forming blind holes may also be formed opposite the pins by the above processes or later machined into the knife member. The indented surfaces 189 respectively provide female coupling surfaces for attaching the knife member 146 to other portions of the cartridge 100. It should be understood that this pin configuration can apply to any of the blade designs disclosed herein.
As shown in FIGS. 16A and 16B, in the starting proximal-most position, the drive member 144 is positioned at the proximal end of the lead screw 134 and the knife member proximal protrusions 168 are disposed within receptacles 198 in the cartridge body 158. The drive member upper surfaces 194 interface with the knife member proximal protrusions 168 to retain the proximal protrusions 168 in the cartridge body receptacles 198, thereby securing engagement between the proximal protrusions 168 and the cartridge body receptacles 198. The distal end of the knife is trapped between a central cavity ceiling 200 of the cartridge body 158 and the lead screw 134 and the knife member body portion 180 is disposed within the longitudinal slot 108, thereby restraining the knife member 146 in a substantially fixed position and orientation relative to the cartridge body 158.
FIG. 16C illustrates interaction between the drive member 144, the knife member 146, and the cartridge body 158 following the “lost motion” portion of the distal motion of the drive member 144 along the lead screw 134. After the drive member distal surfaces 196 come into contact with the knife member distal protrusions 170 causing the knife member 146 to rotate to transfer the proximal protrusions 168 into the drive member proximal receptacles 192, continued rotation of the lead screw 134 results in continued distal motion of the drive member 144 and corresponding distal motion of the knife member 146. During this continued distal motion, the knife member 146 is constrained by both the drive member 146 and the ceiling 200 of the cartridge body 158.
FIG. 17 shows acts of a method 210 of deploying staples from and of articulating a cutting blade in a linear stapling and cutting surgical instrument, in accordance with many embodiments. Any suitable linear stapling and cutting surgical instrument can be used to practice the method 210. For example, the linear stapling and cutting surgical instruments and cartridges described herein can be used to practice the method 210.
In act 212, a knife member having a cutting blade is supported within a housing of a linear stapling and cutting surgical instrument. The housing has a proximal end and a distal end. The cutting blade is configured to cut when the knife member is moved distally. In act 214, a drive member is moved distally through a first movement from a first position to a second position.
In act 216, the knife member is coupled with the housing during the first movement of the drive member to restrain the knife member from moving distally. In many embodiments, the knife member is restrained from moving distally throughout an approximate 4 mm movement of the drive member distally. In many embodiments, coupling the knife member with the housing includes using the drive member to secure engagement between the knife member and the housing. In many embodiments, using the drive member to secure engagement between the knife member and the housing includes interfacing the drive member with the knife member. For example, the knife member can include a first protrusion that interfaces with the drive member and a receptacle of the housing to restrain the knife member during the first movement of the drive member from moving distally.
In act 218, the drive member is used to drive the knife member distally during a second distal movement of the drive member from the second position to a third position. In many embodiments, the knife member includes a drive feature that does not interface with the drive member during the first movement of the drive member and interfaces with the drive member during the second movement of the drive member. In many embodiments, the knife drive feature includes a second protrusion.
In act 220, the drive member is used to deploy staples during the second movement of the drive member. For example, the drive member can include ramp surfaces that interface with staple pushers, which deploy the staples.
FIG. 18 shows optional acts that can be accomplished in the method 210, in accordance with many embodiments. In optional act 222, the knife member is rotated to remove the first protrusion from the housing receptacle. In optional act 224, the first protrusion is received into a receptacle of the drive member. In optional act 226, the first protrusion is accommodated in the drive member receptacle during the second movement of the drive member. And in optional act 228, the knife member is driven along a cam surface thereby raising a distal end of the knife member and lowering the cutting blade into the housing.
supporting a knife member having a cutting blade within a housing of the instrument, the housing having a proximal end and a distal end, the cutting blade being configured to cut when the knife member is moved distally;
moving a drive member distally through a first movement from a first position to a second position;
coupling the knife member with the housing during the first movement of the drive member to restrain the knife member from moving distally; and
using the drive member to drive the knife member distally during a second distal movement of the drive member from the second position to a third position.
receiving the first protrusion into a receptacle of the drive member; and
accommodating the first protrusion in the drive member receptacle during the second movement of the drive member.
a housing included in one of the jaws, the housing including a housing proximal end, a housing distal end, an upper surface extending between the housing proximal and distal ends, a central cavity extending between the housing proximal and distal ends, and a longitudinal slot extending through the upper surface;
a drive member slidably mounted in the housing for movement distally, the knife member being coupled with the housing during a first movement of the drive member distally from a first position to a second position to restrain the knife member from moving distally, the knife member being driven distally by the drive member during a second movement of the drive member distally from the second position to a third position.
23. A demountably attachable cartridge of a surgical instrument, the cartridge comprising:
a housing demountably attachable to an end effector of the surgical instrument, the housing including a proximal end, a distal end, an upper surface extending between the proximal and distal ends, a central cavity extending between the proximal and distal ends, and a longitudinal slot extending through the upper surface;
a lead screw coupled with the housing for rotation relative to the housing;
a rotary input rotationally coupled with the lead screw, the rotary input being configured to couple with a rotary output of the surgical instrument when the housing is attached to the end effector;
a drive member mounted in the housing and coupled with the lead screw for movement along the lead screw in response to rotation of the lead screw, the knife member being coupled with the housing during a first movement of the drive member distally from a first position to a second position to restrain the knife member from moving distally, the knife member being driven distally by the drive member during a second movement of the drive member distally from the second position to a third position.
US13/662,376 2011-10-26 2012-10-26 Surgical instrument with integral knife blade Active 2034-12-19 US9924941B2 (en)
US201161551876P true 2011-10-26 2011-10-26
US13/662,376 US9924941B2 (en) 2011-10-26 2012-10-26 Surgical instrument with integral knife blade
US15/896,472 US20180168572A1 (en) 2011-10-26 2018-02-14 Surgical Instrument With Integral Knife Blade
US15/896,472 Division US20180168572A1 (en) 2011-10-26 2018-02-14 Surgical Instrument With Integral Knife Blade
US20130105545A1 true US20130105545A1 (en) 2013-05-02
US9924941B2 US9924941B2 (en) 2018-03-27
US13/662,376 Active 2034-12-19 US9924941B2 (en) 2011-10-26 2012-10-26 Surgical instrument with integral knife blade
US15/896,472 Pending US20180168572A1 (en) 2011-10-26 2018-02-14 Surgical Instrument With Integral Knife Blade
EP (2) EP2770921B1 (en)
KR (1) KR102019754B1 (en)
EP3090690A4 (en) * 2013-12-31 2017-09-27 Suzhou Touchstone International Medical Science Co., Ltd. Linear stapling and severing apparatus
JP5535084B2 (en) 2008-01-10 2014-07-02 コヴィディエン リミテッド パートナーシップ Imaging system for a surgical device
WO2012112249A1 (en) 2011-02-15 2012-08-23 Intuitive Surgical Operations, Inc. Systems for detecting clamping or firing failure
US8870912B2 (en) 2011-05-31 2014-10-28 Intuitive Surgical Operations, Inc. Surgical instrument with single drive input for two end effector mechanisms
2012-10-26 WO PCT/US2012/062302 patent/WO2013063525A1/en active Application Filing
2012-10-26 CN CN201280052404.4A patent/CN104039251B/en active IP Right Grant
2012-10-26 CN CN201710691391.XA patent/CN107348981A/en active Search and Examination
2012-10-26 EP EP12844202.7A patent/EP2770921B1/en active Active
2012-10-26 EP EP19158752.6A patent/EP3513746A1/en active Pending
2012-10-26 US US13/662,376 patent/US9924941B2/en active Active
2012-10-26 KR KR1020147010488A patent/KR102019754B1/en active IP Right Grant
2012-10-26 JP JP2014539092A patent/JP6210994B2/en active Active
2018-02-14 US US15/896,472 patent/US20180168572A1/en active Pending
CN107106171A (en) * 2014-09-18 2017-08-29 伊西康有限责任公司 Surgical stapler with plurality of cutting elements
EP2770921A4 (en) 2015-07-15
EP2770921A1 (en) 2014-09-03
CN104039251B (en) 2017-09-08
US9924941B2 (en) 2018-03-27
US20180168572A1 (en) 2018-06-21
KR20140079785A (en) 2014-06-27
JP2014534863A (en) 2014-12-25
CN104039251A (en) 2014-09-10
EP3513746A1 (en) 2019-07-24
KR102019754B1 (en) 2019-09-10
JP6210994B2 (en) 2017-10-11
WO2013063525A1 (en) 2013-05-02
EP2770921B1 (en) 2019-02-27
CN107348981A (en) 2017-11-17
US20180140368A1 (en) 2018-05-24 Surgical end effectors having angled tissue-contacting surfaces
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:BURBANK, WILLIAM A.;REEL/FRAME:029566/0868