Abstract:
A surgical tool system includes a surgical tool shaft having a distal end and a proximal end. A plurality of surgical tool tips detachably connect to the distal end of the shaft. The surgical tool shaft includes a low power electrical interface, a high power electrical interface, and a mechanical interface.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    The present application claims the benefit of U.S. Provisional Application 61/935,227 (Attorney Docket No. 42369-707.101), filed on Feb. 3, 2014, the full disclosure of which is incorporated herein by reference. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    1. Field of the Invention 
         [0003]    The present invention relates generally to medical devices and methods. More particularly, the present invention relates to surgical tool systems for endoscopic and laparoscopic procedures where a single tool shaft can be used with multiple surgical tool tips. 
         [0004]    Laparoscope and other endoscopic surgical procedures are widely used and have replaced many open surgical procedures. Laparoscopic procedures are performed within body cavities, such as the abdomen or thorax, and rely on introducing a shaft through a small incision, trocar or other access point through tissue which provide access into the cavity. In laparoscopic procedures, the shaft manipulates a tool or end effector to perform a surgical protocol while viewing the surgical field within the cavity using a camera. One drawback in performing laparoscopic and other endoscopic procedures is the need to frequently exchange tools through a limited number of access points. 
         [0005]    It has been proposed to increase the efficiency of laparoscopic and other endoscopic procedures by introducing a plurality of surgical tool tips into the surgical field, such as an insufflated abdomen or thorax, and subsequently exchanging tools on a single or limited number of tool shafts, thus avoiding the need to remove and exchange complete tools through the access points. Such surgical tools exchange systems and procedures are described, for example, in commonly owned U.S. Patent Publication No. 2013/0150871, the full disclosure which is incorporated herein by reference. 
         [0006]    2. Background Art 
         [0007]    U.S. Patent Publication 2013/0150871 has been described above. See also U.S. Pat. Nos. 5,925,002; 6,309,397; and 7,492,116; as well as U.S. Publication Nos. 2003/0114731; 2005/0043718; U.S. 2005/0209607; U.S. 2006/0041273; U.S. 2007/0198000; U.S. 2008/0108871; U.S. 2008/0147096; US. 2008/0167672; U.S. 2008/0275480; U.S 2009/0005638; and U.S. 2013/0066304. 
       SUMMARY OF THE INVENTION 
       [0008]    In a first aspect, the present invention provides a surgical tool system comprising a surgical tool shaft having a distal end and proximal end. The surgical tool shaft includes a low power electrical interface, a high power electrical interface, and a mechanical interface. The system further comprises a plurality of surgical tools tips, wherein individual tool tips are detachably connectable to the distal end of the shaft. The individual tool tips will also include at least one of a low power electrical interface, a high power electrical interface, and a mechanical interface, wherein the interfaces on the tool tips are disposed on the tools so that they will mate with the corresponding interface on the shaft when the tool tip is mounted on the shaft. The low power electrical interface may provide power to sensors on the tool tip and/or receives data or other low power information from the tool tip. Alternatively, the low power electrical interface may provide control information to motors on the tool tip and/or receive control data or other low power information from the tool tip. The high power electrical interface will typically drive motors, power illumination, power cautery, power electrosurgical tools, or the like on the tool tip, while the mechanical interface will typically allow conventional grips, levers, or other manual drivers on the shaft or an associated handle to mechanically drive jaws, scissors, or the like on the tool tips. 
         [0009]    In a first embodiment, at least some of the surgical tool tips have sensors which connect to the low power electrical interface. Sensors may comprise temperature sensors, environmental sensors, diagnostics sensors, and the like. In the second embodiment, at least some of the surgical tool tips may have cameras which connect to the low power electrical interface. In a third embodiment, at least some of the surgical tool tips may have electrodes which connect to the high power electrical interface, such as radiofrequency electrodes for performing electrosurgery and/or electrocautery. The electrodes may also comprise resistance heaters, ablation elements, cutting elements, and the like. In a fourth embodiment, at least some of the surgical tool tips will comprise electrical motors which connect to the high power electrical interface and optionally to the low power electrical interface as well for control and other purposes. Electric motors can be connected to the high and/or the low power interface and may drive tools or may be connected to cameras for adjusting focus or magnification. In a sixth embodiment, the mechanical interface will provide linear actuation for a tool on the surgical tip, such as for driving scissors, forceps, or other pivoted elements. In an eighth embodiment the mechanical interface will provide rotational actuation to drive, for example, drills, burrs, abrading elements, and the like. In some arrangements, the mechanical interface may provide both rotational and linear actuation for selective connection to any of the end effectors described above for either or both rotational and linear actuation. 
         [0010]    In a second aspect of the present invention, a tool system comprises a surgical tool shaft have a distal and a proximal end. A surgical tool tip is detachably connectable to the distal end of the shaft, and the tool shaft includes a surface feature which mates with a lock mechanism on the tool tip so that rotation of the shaft relative to the tool tip releases the tip from the a holding member. For example, a shaft may have a cylindrical outer surface and the surface feature may comprise at least one flat face or facet on the cylindrical surface which engages a cam or other similar mechanism in the surgical tool tip to cause release of the tip from the holder. 
         [0011]    In a third aspect of the present invention, a tool tip cassette system comprises a plurality of tool carrier segments at lease some of which are connected with articulating joints. The cassette system further comprises a cassette manipulator including a handle and an attachment shaft. The shaft is configured to pass through tissue from an external location, typically through a cannula or a direct incision in the tissue, to a location in the body cavity. A distal end of the attachment shaft is configured to be detachably secured to the tool carrier while the tool carrier is within the body cavity. A handle is usually attached to the shaft at the external location and can be used to manipulate the tool carrier segments, for example by pulling the segments against an inner wall of a patient&#39;s busfrias thorax. Typically, the cassette manipulator will include a mechanism to selectively release the tool carrier from the shaft/or to selectively to release the manipulator from the shaft. In still other embodiments, the manipulator may provide mechanisms on the handle which allow the physician to reconfigure the tool carrier segments within the body cavity, for example, by straightening or bending the carrier segments, by releasing individual tool holders from each segments to make the circle tool tips accessible, or the like. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0012]      FIG. 1  illustrates a surgical tool system and a tool tip cassette system constructed in accordance with the principles of the present invention. 
           [0013]      FIG. 2  illustrates a surgical tool shaft as being introduced to a surgical tool tip. 
           [0014]      FIG. 3  is a detailed view of the surgical tool shaft entering a surgical tool tip while the tool tip is retained within a holding unit within the tool tip cassette system. 
           [0015]      FIGS. 4A-4C  illustrate in detail a distal end of the surgical tool shaft being introduced into a surgical tool tip. 
           [0016]      FIGS. 5A-5D  illustrate details of the locking mechanism which allows the distal end of the surgical tool shaft to be rotated in order to release the shaft from the tool tip. 
           [0017]      FIG. 6  illustrates the detailed construction of a proximal end of the surgical tool shaft where it is connected to a handle. 
           [0018]      FIG. 7  illustrates the surgical tool system engaging a surgical tool tip held in a deployed tool tip cassette system. 
           [0019]      FIGS. 7A-7C  illustrate the straight, deployed, and the tool holder deployed configurations of the tool tip cassette system of the present invention. 
           [0020]      FIG. 8  illustrates the tool tip cassette system manipulator being used in a patient. 
           [0021]      FIG. 9  illustrates the surgical tool manipulator prior to the attachment to a tool cassette. 
           [0022]      FIGS. 10A-10B  illustrate the surgical tool manipulator of the present invention attached to a deployed tool cassette system. 
       
    
    
     INCORPORATION BY REFERENCE 
       [0023]    All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. 
       DETAILED DESCRIPTION OF THE INVENTION 
       [0024]      FIG. 1  illustrates a complete tool system with cassette. The tool system  10  includes a handle  12  and shaft  14 . A cassette system  16  includes a plurality of individual segments  18  with articulating joints  20  and deployable tool holders  22 , each of which cradles a removable surgical tool tip  36  ( FIG. 2 ). 
         [0025]    The tool system  10  is shown in more detail in  FIG. 2 . The handle  12  includes a shaft rotator  26 , a fixed finger grip  28  and a thumb actuator  30 . The handle  12  typically house motors, controllers, and other components for driving and interfacing with the individual tool tips  36 . The thumb actuator  30  will typically be connected to manipulate the tools in some desired way, for example, by mechanically opening and closing scissors, forceps, or other tool elements. Alternatively, the thumb actuator could actuate an electric motor to rotate the tool element, such as a burr, drill, or the like. Other features on the handle include a trocar button  32  and a trocar mode selector  34 . 
         [0026]    The shaft  14  of the tool system will typically (but not necessarily) have a pointed, electro-surgical, or other tissue-penetrating tip to allow direct introduction through tissue, i.e. not through a previously placed cannula. While not necessary, such shafts with tissue-penetrating element could be introduced through cannulas or pre-formed incisions. 
         [0027]    An exemplary surgical tool tip  36  comprises a cassette-locking element, such as pawl  38 , a printed circuit board or other low power electrical interface  40 , and the like. A second or mating low power interface  42  will typically be provided on the shaft  14  in order to interconnect with the interface  40  on the tool. The tool  36  itself may comprise mechanical elements such as jaws  46 , although other mechanical and non-mechanical end effectors may also be provided, such as electrodes, drills, cameras, electrodes, and the like. 
         [0028]      FIG. 3  provides a detailed view of the distal end of the shaft entering the tool  36  while it is held within a deployed tool holder  22  which is part of the cassette system  16 . The tool holder is raised from a bay in the segment  18 , and the distal end of the shaft  14 , which is typically less than 3 mm in outside diameter, may be introduced into a larger or full sized tool tip, typically 8 mm, and thereafter may be locked onto the shaft, typically by the paw  38  ( FIG. 2 ). 
         [0029]      FIG. 4A  shows the distal end of the shaft  14  being introduced the surgical tool tip  36  where a rotational motion can drive the tool, such as graspers, cutters, camera zoon/focus, morcellator, or the like. Rotational motion is converted by a thrust bearing  48  where splines  50  on the tool tip engage a rotational mechanism to convert rotational motion into liner motion via a lever  52 . 
         [0030]      FIGS. 4B and 4C  shows an alternative construction of the tool tip  36 ′ and the distal end of shaft  14 ′ with a collet leaf  56  (retracted in  FIG. 4B  and exposed in  FIG. 4C ) which is received into a collet leaf cavity  58  for locking and releasing the tool tip into a tool holder by canting latch element  60 . A rotational alignment detent  62  is also provided.  FIG. 4B  shows the shaft  14 ′ prior to insertion into tool  36 ′, and  FIG. 4C  shows the shaft inserted into the tool. 
         [0031]    Details of the mechanism for locking and unlocking the shaft  14 ′ into the surgical tool tip  36 ′ are provided in  FIGS. 5A-4D . Exploded views are shown in  FIGS. 5A and 5B  where a lock pin carrier  70  includes a trocar push off feature  72 , lock tip  74 , spring  76  and spring caps  78 . An unlocked configuration is shown in  FIG. 5C  and a locked configuration is shown in  FIG. 5D . By rotating the shaft  14  through 90°, as indicated by the arrow in  FIG. 5C , flat facets or surfaces on the cylindrical face of the distal end of the shaft  14  allow the lock pins  74  to drop under the force of springs  76 , allowing the spring caps  78  to disengage the locking lever. 
         [0032]      FIG. 6  illustrates an exploded view of the connection of the handle  12  of the tool system  10  to the shaft  14 . Grounding pins  80  are movably received into grounding pin pockets  82 , and a handle collar  84  may be pushed forward to disengage the grounding pins or be pulled back to engage the grounding pins, thus allowing a nose cone  86  to be selectively rotated. This allows the 90° rotation which is used for locking and unlocking the tool tip to the shaft of the device. 
         [0033]      FIG. 7  illustrates the tool system  10  and cassette system  16 , where the cassette system  16  may be sutured in place with suture  90 . 
         [0034]      FIGS. 7A-7C  illustrate various configurations of the tool cassette system  16 . A linear configuration is shown in  FIG. 7A . The linear configuration is typically used for introducing the cassette into the patient. For thoracoscopic procedures, the individual segments  18  and tools  36  may have non-circular cross sections in order to minimize the need to distract adjacent ribs for introduction. The tool cassettes are shown in their stable, curved configuration in  7 B and further shown with individual tool holders  22  deployed in  FIG. 7C . 
         [0035]    Referring now to  FIG. 8 , a cassette manipulator  100  is shown attached to a center segment of a tool cassette deployed in the thorax of a patient. As better seen in FIGS.  9  and  10 A- 10 B, the cassette manipulator  100  includes a handle  102  and a shaft  104  where a distal tip  106  of the shaft can be detachably removed into a center segment  108  of the tool cassette system  116 . The center segment  108  will typically not carry a tool and be provided as an interface for the shaft  104 . After the tool cassette has been introduced into the thorax of the patient, as shown in  FIG. 8 , the shaft  104  may be transcutaneously introduced, typically using the sharpened or otherwise tissue-penetrating tip  106 , and then engaged into the segment  108 . The handle  102  can then be used to pull the cassette upwardly against the inner wall of the thorax, and the handle then ratcheted down against the outer skin of the patient in order to hold the tool cassette in place. At the end of the procedure, a release button  120  can be pressed to release the cassette. A second release button  122  is provided to disengage the ratchet which holds the handle in place while a tip to the shaft. 
         [0036]    While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.