Source: http://www.google.es/patents/EP1645238A1?cl=en
Timestamp: 2017-12-16 01:48:57
Document Index: 375414950

Matched Legal Cases: ['Application No. 10', 'Application No. 10', 'Application No. 10', 'Application No. 10', 'Application No. 60', 'Application No. 60']

Patente EP1645238A1 - Mechanism for dividing tissue in a hemostat-style instrument - Google Patentes
Open electrosurgical forceps for sealing tissue are provided which include first and second shaft portions pivotably associated with one another. Each shaft portion has a jaw member disposed at a distal end thereof. Each of the jaw members includes an electrically conductive sealing surface adapted to...http://www.google.es/patents/EP1645238A1?cl=en&utm_source=gb-gplus-sharePatente EP1645238A1 - Mechanism for dividing tissue in a hemostat-style instrument
Número de publicación EP1645238 A1
Número de solicitud EP20050021780
También publicado como CA2522317A1, CA2522317C, DE602005020097D1, EP1645238B1, US7955332, US8123743, US20060079891, US20080312653
Número de publicación 05021780, 05021780.1, 0521780, 2005021780, 200521780, EP 1645238 A1, EP 1645238A1, EP-A1-1645238, EP05021780, EP1645238 A1, EP1645238A1, EP20050021780
Inventores Michael C. Moses, Gene H. Arts, Gary M. Couture, Kristin D. Johnson
Citas de patentes (6), Citada por (59), Clasificaciones (14), Eventos legales (21)
EP 1645238 A1
The open electrosurgical forceps according to claim 1, wherein the actuator is integrally associated with the cutting element.
The open electrosurgical forceps according to claim 1 or 2, wherein the cutting mechanism is pivotable about a pivot which connects the first and second jaw members.
The open electrosurgical forceps according to any one of the preceding claims, wherein the actuator is spaced a distance from the first shaft portion.
The open electrosurgical forceps according to any one of the preceding claims, wherein the actuator selectively activates the cutting element when moved relative to the first shaft portion.
The open electrosurgical forceps according to any one of the preceding claims, wherein the cutting mechanism includes;
The open electrosurgical forceps according to claim 6, wherein the cutting element is supported in the slot of the jaw member such that proximal displacement of the drive rod urges the cutting element from within the slot of the jaw member to cut tissue.
The open electrosurgical forceps according to any one of the preceding claims, wherein the cutting element includes at least one angled slot defined therethrough which receives a pivot pin fixed to one of said jaw members.
The open electrosurgical forceps according to claim 8, wherein each angled slot formed in the cutting element includes a first portion in close proximity to the sealing surface and a second portion extending distally and away from the sealing surface.
The open electrosurgical forceps according to claim 9, wherein proximal movement of the drive rod urges the cutting element from the first position to the second position by a camming action between the pin and the slot formed in the cutting element.
The open electrosurgical forceps according to any one of claims 6 to 10, further comprising a biasing element for urging the drive rod to a distal-most position.
The open electrosurgical forceps according to any one of the preceding claims, wherein the cutting element is pivotably disposed within the slot of the jaw member.
The open electrosurgical forceps according to claim 12, wherein the cutting element extends out through the jaw member and defines a camming surface.
The open electrosurgical forceps according to claim 13, wherein the second shaft portion reciprocably supports the actuator, the actuator being movable from a first position spaced from the cutting element to a second position in contact with the cutting element.
The open electrosurgical forceps according to claim 14, wherein upon displacement of the actuator from the first position to the second position, the actuator engages the camming surface of the cutting element and urges the cutting element from the first position to the second position.
The open electrosurgical forceps according to any one of the preceding claims, further comprising a biasing element configured to urge the cutting element to the first position.
The open electrosurgical forceps according to any one of the preceding claims, wherein movement of the actuator pivots the cutting element between the first and second positions.
The open electrosurgical forceps according to claim 18 wherein the cutting mechanism includes:
The open electrosurgical forceps according to claim 19 wherein the cutting element is operatively engaged in the slot of the one jaw member such that axial displacement of the drive rod results in transverse displacement of the cutting element from the slot to cut tissue disposed between the jaw members.
This application claims the benefit of priority to U.S. Provisional Application Serial No. 60/616,968 filed on October 8, 2004 entitled "MECHANISM FOR DIVIDING TISSUE IN A HEMOSTAT-STYLE INSTRUMENT" the entire contents of which being incorporated by reference herein.
A forceps is a plier-like instrument which relies on mechanical action between its jaws to grasp, clamp and constrict vessels or tissue therebetween. So-called "open forceps" are commonly used in open surgical procedures whereas "endoscopic forceps" or "laparoscopic forceps" are, as the name implies, used for less invasive endoscopic surgical procedures. Electrosurgical forceps (open or endoscopic) utilize both mechanical clamping action and electrical energy to effect hemostasis by heating tissue and blood vessels to coagulate and/or cauterize tissue.
Certain surgical procedures require more than simply cauterizing tissue and rely on the unique combination of clamping pressure, precisely controlling the application of electrosurgical energy and the gap distance (i.e., distance between opposing jaw members or opposing conducting surfaces when closed about tissue) to "seal" tissue, vessels and certain vascular bundles.
Many endoscopic vessel sealing instruments have been designed which incorporate a knife or blade member which effectively severs the tissue after forming a tissue seal. For example, commonly-owned U.S. Application Serial Nos. 10/116,944; 10/179,863; and 10/460,926 all describe endoscopic instruments which effectively seals and cuts tissue along the tissue seal. Other instruments include blade members or shearing members which simply cut tissue in a mechanical and/or electromechanical manner and are relatively ineffective for vessel sealing purposes.
FIG. 1C is a side, elevational view of the forceps of FIGS. 1A and 1 B shown in a closed position and the cutting assembly shown in an unactuated position;
FIG. 1 D is a side, elevational view of the forceps of FIGS. 1A-1C shown in a closed position and the cutting assembly shown in an actuated position;
Referring now to FIGS. 1A-1D, a forceps or hemostat for use in open surgical procedures is generally designated as 100. Forceps 100 includes a first elongated shaft portion 110 and a second elongated shaft portion 120 each having a proximal end 112 and 122, respectively. In the drawings and in the descriptions which follow, the term "proximal", as is traditional, will refer to the end of forceps 100 which is closer to the user, while the term "distal" will refer to the end which is further from the user.
As briefly discussed above, jaw members 132, 134 are selectively movable about pivot pin 135 from the open position to the closed position for grasping tissue therebetween. Jaw members 132 and 134 are generally symmetrical and include similar component features which cooperate to permit facile rotation about pivot pin 135 to effect the grasping and sealing of tissue. As a result and unless otherwise noted, jaw member 132 and the operative features associated therewith are initially described herein in detail and the similar component features with respect to jaw member 134 will be briefly summarized thereafter. Moreover, many of the features of jaw members 132 and 134 are described in detail in commonly-owned U.S. Patent Application Serial Nos. 10/284,562, 10/116,824, 09/425,696, 09/178,027 and PCT Application Serial No. PCT/US01/11420 the contents of which are all hereby incorporated by reference in their entirety herein.
It is envisioned that one of the jaw members, e.g., 132, includes at least one stop member (not shown) disposed on the inner facing surface of the electrically conductive sealing surface 132a (and/or 134a). Alternatively or in addition, the stop member(s) may be positioned adjacent to the electrically conductive sealing surfaces 132a, 134a or proximate the pivot pin 135. The stop member(s) is/are designed to define a gap between opposing jaw members 132 and 134 during sealing. The separation distance during sealing or the gap distance is within the range of about 0.001 inches (~0.03 millimeters) to about 0.006 inches (~0.016 millimeters).
A detailed discussion of these and other envisioned stop members as well as various manufacturing and assembling processes for attaching, disposing, depositing and/or affixing the stop members to the electrically conductive sealing surfaces 132a, 134a are described in commonly-assigned, co-pending PCT Application Serial No. PCT/US01/11222 and U.S. Application Serial No. 10/471,818 which are both hereby incorporated by reference in their entirety herein.
With reference to FIGS. 1B-1D, a method of using forceps 100 will now be described in detail. As seen in FIG. 1 B, with shaft portions 110, 120 in the open position, such that jaw members 132, 134 are spaced from one another, and with cutting assembly 140 in the first position (i.e., within slot 134b), jaw members 132, 134 are maneuvered around the target tissue "T". As seen in FIG. 1C, following manipulation and positioning of jaw members 132, 134 about target tissue "T", forceps 100 is moved from the open position to the closed position. In particular, proximal ends 112, 122 of shaft portions 110 and 120 are moved toward one another, in the direction of arrows "A", to thereby proximate jaw members 132, 134 toward one another.
In so doing, target tissue "T" is clamped or grasped between jaw members 132, 134. Desirably, the user then activates a hand switch or a foot switch (not shown) to provide electrosurgical energy to each jaw member 132, 134 to communicate energy through target tissue "T" held therebetween to effect a tissue seal. Once target tissue "T" is sealed, as seen in FIG. 1 D, cutting mechanism 140 is actuated, e.g., arm portion 142 is moved toward shaft portion 110 in the direction of arrow "B", to sever target tissue "T" along the tissue seal. In particular, upon movement of arm portion 142 cutting element 144 pivots about pivot pin 135 and deploys from jaw member 134 toward jaw member 132 to thereby slice, cut and/or otherwise divide target tissue "T" along the previously formed tissue seal.
As seen in FIGS. 2B and 2C, in operation and following application of electrosurgical energy to jaw members 232, 234, to thereby seal the target tissue held therebetween, the user activates finger tab 246 to thereby urge drive rod 242 in a proximal direction, as indicated by arrow "A". In so doing, cutting element 244 is urged in an angular direction relative to the longitudinal axis, as indicated by arrows "B". In particular, cutting element 244 is drawn both proximally and toward jaw member 232 (i.e., deployed from slot 234b formed in sealing surface 234a of jaw member 234, to thereby slice the target tissue which is clamped between jaw members 232, 234. In other words, cutting element 244 is drawn in direction "B" by the camming action created between slots 244a, 244b and pins 250. While cam slots 244a, 244b may be diagonal, as seen in FIG. 2D, cutting element 244 may be provided with cam slots 244a' and 244b' having a diagonal portion and a longitudinally extending portion integrally connected to the diagonal portion to thereby by create a slicing or cutting motion for cutting element 244.
As seen in FIGS. 3A and 3B, following application of electrosurgical energy to jaw members 132, 134 to seal tissue held therebetween, the user advances sheath 342 a distal direction, as indicated by arrow "A", to engage camming surface 346 of cutting element 344 and urge cutting element 344 out of slot 334b in the direction of arrow "B" to sever tissue. Following the cutting of the tissue, sheath 342 is withdrawn in a proximal direction until camming surface 346 of cutting element 344 is disengaged. The force of biasing member 348 automatically returns cutting mechanism 340 into slot 334b of jaw member 334.
In operation, as seen in FIGS. 3C and 3D, as cutting element 344 is urged out of slot 334b of jaw member 334, in the direction of arrow "B" (FIG. 3B), notch 362 closes against the bias created by arm 360. Following the cutting of the target tissue, sheath 342 is withdrawn in a proximal direction until camming surface 346 of cutting element 344 is disengaged. The biasing force created by arm 360 automatically returns cutting mechanism 340 into slot 334b of jaw member 334.
Turning now to FIGS. 4A and 4B an alternative embodiment includes a cutting element 444 is pivotably connected to a drive rod 452 by a pin 454. In this manner, as drive rod 452 is driven in a distal direction, as indicated by arrow "A", cutting element 444 is pivoted about pin 450 and urged out of slot 334b of jaw member 334. Following the cutting step, drive rod 452 is withdrawn in a proximal direction to urge cutting element 444 back into jaw member 334.
For example, it is also contemplated that forceps 100, 200 and/or 300 (and/or the electrosurgical generator used in connection therewith) may include a sensor or feedback mechanism (not shown) which automatically selects the appropriate amount of electrosurgical energy to effectively seal the particularly-sized tissue grasped between the jaw members. The sensor or feedback mechanism may also measure the impedance across the tissue during sealing and provide an indicator (visual and/or audible) that an effective seal has been created between jaw members 132 and 134. Commonly-owned U.S. Patent Application No. 10/073,761, filed on February 11, 2002, entitled "Vessel Sealing System"; U.S. Patent Application No. 10/626,390, filed on July 24, 2003, entitled "Vessel Sealing System"; U.S. Patent Application No. 10/427,832, filed on May 1, 2003, entitled "Method and System for Controlling Output of RF Medical Generator"; U.S. Patent Application No. 10/761,524, filed on January 21, 2004, entitled "Vessel Sealing System"; U.S. Provisional Application No. 60/539,804, filed on January 27, 2004, entitled "Method of Tissue Fusion of Soft Tissue by Controlling ES Output Along Optimal Impedance Curve"; U.S. Provisional Application No. 60/466,954; filed on May 1, 2003, entitled "Method and System for Programming and Controlling an Electrosurgical Generator System"; and U.S. Patent No. 6,398,779, disclose several different types of sensory feedback mechanisms and algorithms which may be utilized for this purpose. The contents of these applications are hereby incorporated by reference herein.
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Clasificación cooperativa A61B2018/1457, A61B2018/00404, A61B17/2812, A61B2018/0063, A61B18/1442, A61B2018/00345, A61B2018/00601, A61B17/3201, A61B17/32, A61B2018/00619, A61B2018/146
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