(19)
(11)EP 2 900 151 B1

(12)EUROPEAN PATENT SPECIFICATION

(45)Mention of the grant of the patent:
29.04.2020 Bulletin 2020/18

(21)Application number: 13774294.6

(22)Date of filing:  20.09.2013
(51)International Patent Classification (IPC): 
A61B 17/29(2006.01)
A61B 17/00(2006.01)
(86)International application number:
PCT/US2013/060803
(87)International publication number:
WO 2014/052177 (03.04.2014 Gazette  2014/14)

(54)

DETACHABLE END EFFECTOR AND LOADER

ABNEHMBARER ENDEFFEKTOR UND LADEVORRICHTUNG

EFFECTEUR TERMINAL DÉTACHABLE ET CHARGEUR


(84)Designated Contracting States:
AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

(30)Priority: 26.09.2012 US 201213627177

(43)Date of publication of application:
05.08.2015 Bulletin 2015/32

(73)Proprietor: Ethicon LLC
00969 Guaynabo (PR)

(72)Inventors:
  • PARIHAR, Shailendra K.
    Mason, Ohio 45040 (US)
  • HABERSTICH, Wells D.
    Loveland, Ohio 45140 (US)

(74)Representative: Carpmaels & Ransford LLP 
One Southampton Row
London WC1B 5HA
London WC1B 5HA (GB)


(56)References cited: : 
WO-A1-2012/040183
JP-A- 2005 261 734
WO-A2-2013/048963
  
      
    Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention).


    Description

    BACKGROUND



    [0001] The present invention relates in general to surgical devices, and more particularly to devices for use in minimally invasive surgery.

    [0002] Surgical procedures are often used to treat and cure a wide range of diseases, conditions, and injuries. Surgery often requires access to internal tissue through open surgical procedures or endoscopic surgical procedures. The term "endoscopic" refers to all types of minimally invasive surgical procedures including laparoscopic, arthroscopic, natural orifice intraluminal, and natural orifice transluminal procedures. Endoscopic surgery has numerous advantages compared to traditional open surgical procedures, including reduced trauma, faster recovery, reduced risk of infection, and reduced scarring. Endoscopic surgery is often performed with an insufflatory fluid present within the body cavity, such as carbon dioxide or saline, to provide adequate space to perform the intended surgical procedures. The insufflated cavity is generally under pressure and is sometimes referred to as being in a state of pneumoperitoneum. Surgical access devices are often used to facilitate surgical manipulation of internal tissue while maintaining pneumoperitoneum. For example, trocars are often used to provide a port through which endoscopic surgical instruments are passed. Trocars generally have an instrument seal, which prevents insufflatory fluid from escaping while an instrument is positioned in the trocar.

    [0003] WO2012/040183 describes a laparoscopic instrument with attachable end effector.

    [0004] While a variety of different minimally invasive surgical devices are known, no one has made or used the surgical devices in accordance with the present invention.

    SUMMARY



    [0005] The surgical device according to the invention is defined in claim 1. Preferred embodiments are defined in the dependent claims.

    [0006] The surgical device comprises an elongate shaft having an outer tube and an inner rod positioned in the outer tube. The outer tube and inner rod each comprise a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the elongate shaft. The end effector comprises an outer casing comprising a first detent mating feature adapted to engage the distal end of the outer tube; an inner shuttle axially movable relative to the outer case, the shuttle comprising a second detent mating feature to engage the distal end of the inner rod, wherein the second detent mating feature comprises a pair of proximally oriented prongs, each having a medially oriented tooth adapted to engage a notch on the inner rod; a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing. A tubular loader is sized to receive the end effector, the tubular loader comprising third detent mating feature adapted engage end effector.

    [0007] The first, second, and third detent mating features may have a threshold disengagement force F1, F2, and F3, respectively, of the following relative magnitudes: F1 < F3 < F2. The first detent mating feature may comprise a leaf spring on the outer casing adapted to engage a notch on the outer tube. The third detent mating feature may comprise a leaf spring on the tubular loader adapted to engage a notch on the outer casing. The distal end of the outer tube may comprise a sloped surface adapted to engage and laterally spread the prongs thereby disengaging the teeth from the notch on the inner rod.

    [0008] Another disclosed surgical device comprises an elongate shaft comprising an outer tube and an inner rod positioned in the outer tube, the outer tube and inner rod each comprising a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the elongate shaft. The end effector comprises an outer casing comprising a first mating feature adapted to engage the distal end of the outer tube; an inner shuttle axially moveable relative the outer casing, the shuttle comprising a second mating feature adapted to engage the distal end of the inner rod; and a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing. The second mating feature comprises a pair of proximally oriented prongs, each having a medially oriented tooth adapted to engage a notch on the inner rod. The distal end of the outer tube comprises a sloped surface adapted to engage and laterally spread the prongs thereby disengaging the teeth from the notch on the inner rod. The first mating feature may comprise a detent mechanism.

    [0009] Yet another disclosed surgical device comprises an elongate shaft comprising an outer tube and an inner rod positioned in the outer tube, the outer tube and inner rod each comprising a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the elongate shaft. The end effector comprises an outer casing and a means to attach the outer casing to the outer tube; an inner shuttle axially moveable relative the outer casing and a means to attach the shuttle to the inner rod; and a pair of surgical jaws having an opened position and closed position dependant on the relative axial position of the shuttle and casing. A tubular loader is sized to receive the end effector and includes a means to attach the end effector in the tubular loader.

    BRIEF DESCRIPTION OF DRAWINGS



    [0010] While the specification concludes with claims which particularly point out and distinctly claim the invention, it is believed the invention will be better understood from the following description taken in conjunction with the accompanying drawings. Unless otherwise indicated, the figures are not necessarily drawn to scale, but rather to illustrate the principles of the invention.

    Fig. 1 depicts an example of a loader, end effector, shaft, and actuator;

    Fig. 2 depicts an exploded view of the shaft;

    Fig. 3 depicts a cross-sectional view of a portion of the shaft;

    Fig. 4 depicts a perspective view of the end effector;

    Fig. 5 depicts an exploded view of the end effector;

    Fig. 6 depicts a side view of the loader and end effector;

    Fig. 7 depicts a cross-sectional view of the end effector locked in the loader; and

    Fig. 8 depicts a cross-sectional view of the end effector attached to the shaft and unlocked in the loader.


    DETAILED DESCRIPTION



    [0011] The figures illustrate one example a laparoscopic surgical instrument system. The elongate shaft (20) comprises an outer tube (23) and an inner rod (24) positioned in the outer tube (23). The elongate shaft comprises a distal end (21) and a proximal end (22). The elongate shaft (20) may be rigid and adapted for insertion into a body cavity through an access device, such a trocar, or through direct percutaneous insertion without an access device. The elongate shaft (20) may also be flexible and sized for insertion through the working channel of a flexible endoscope. The rigid shaft embodiment is well suited for laparoscopic surgical procedures, and the flexible shaft embodiment is well suited for natural orifice intraluminal and natural orifice transluminal procedures.

    [0012] An actuator (30) is operably connected to the proximal ends (22) of the outer tube (23) and the inner rod (24). The actuator (30) causes the inner rod (24) to move relative the outer tube (23). In this embodiment the actuator (30) is a manual pistol grip handle; however, a variety of other manual actuators could also be used, including a scissor grip handle, a syringe grip handle, endoscopic rotary knobs, and the like. The actuator (30) could also take the form of a robotic interface, such as an DAVINCI puck, a housing comprising gears or pulleys, servomechanisms, and the like.

    [0013] The end effector (10) is adapted for in vivo attachment to and detachment from the elongate shaft (20). An inner shuttle (14) is axially moveable relative the outer casing (12). The shuttle comprises a mating feature adapted to attach to the distal end of the inner rod (24). The specific mating feature can vary, but in this embodiment the mating feature comprises a detent-type mechanism comprising a pair of proximally oriented prongs (14A), each functioning as leaf spring to bias a medially oriented tooth (14B) to engage the notch (27B) on the inner rod (24).

    [0014] A pair of surgical jaws (11A, B) have an opened position and closed position dependant on the relative axial position of the shuttle (14) and the outer casing (12). A clevis (15) is fixed to the outer casing (12). A bar linkage mechanism (13) cooperates with the clevis (15) to translate the axial motion of the shuttle (14) to open and close the jaws (11); however, a variety of other known mechanisms can be used to effect operation of the jaws (11). In this embodiment, the jaws (11) are shown as a grasper; however, a variety of other tissue manipulating jaws could also be used, including dissectors, sheers, babcocks, forceps, staplers, clip appliers, and the like. Non-jawed end effectors could also be employed such as hook knives, snares, retractors, and the like. In the case of end effectors that require energy, appropriate energy transmission mechanisms known in the art can be added. For instance, appropriate electrical connections can be added between the shaft (20) and end effector (10) to enable bi-polar forceps. Similarly, an ultrasonic transducer and waveguide can be added for the ultrasonic shears end effector.

    [0015] The end effector (10) comprises a mating feature (17) adapted to attach the outer casing (12) to the outer tube (23). In this embodiment the mating feature (17) is a detent-type mechanism comprising two leaf springs, positioned 180 degrees from each other on the outer casing (12), each having a medial facing tooth. As the outer tube (23) slides distally into the outer casing (12), and the leaf springs provide a biased snap-to-lock engagement of the teeth into the notch (27A). Other mating features could also be used, including threads, collets, bayonets, and the like. Keyway features (19) are sized and adapted to engage the spline features (28) on the outer tube (23) to facilitate rotational coupling when the outer tube (23) is attached to the outer casing (12).

    [0016] A loader (40) comprises a handle (45), a shaft (43), and a distal tube (41) that may articulate relative the shaft (43). The tube (41) is sized to receive the end effector (10). The tube (41) comprises a mating feature (42) adapted to attach the end effector (10) inside the tube (41). In this embodiment the mating feature (42) is a detent-type mechanism comprising two leaf springs, positioned 180 degrees from each other on the tube (41), each having a medial facing tooth. As the end effector (10) slides into the tube (41), and the leaf springs provide a biased snap-to-lock engagement of the teeth into the notch (18). Other mating features could also be used, including threads, collets, bayonets, and the like.

    [0017] The three mating features (17, 14A, and 42) each have a threshold axial force that will cause the respective components to disengage. For instance, the threshold disengagement force of the mating feature (17) is the axial force required to separate the outer housing (12) from the outer tube (23). Preferably, the relative magnitudes of the threshold disengagement forces are in accordance with the following equation:

    where
    F1 is
    the threshold disengagement force between the outer housing (12) and the outer tube (23);
    F2 is
    the threshold disengagement force between the shuttle (14) and inner rod (24);
    F3 is
    the threshold disengagement force between the loader tube (41) and the end effector (10);


    [0018] During surgery, the distal end (21) of the shaft (20) is inserted into the body cavity, such as the abdomen, pelvis, thorax, etc. The end effector (10) is attached into the tube (41) and also introduced into the body cavity, typically through an access port. The loader tube (41) can be articulated to facilitate bringing the end effector (10) into axial alignment with the shaft (20). The distal end (21) is then inserted into the end effector (10). The outer tube (23) slides distally into the outer casing (12) until the leaf springs of the mating feature (17) provide a biased snap-to-lock engagement into the notch (27A), thus attaching the outer casing (12) to the outer tube (23). The inner rod (24) slides distally into the shuttle (14) until the prongs (14A) provide a biased snap-to-lock engagement with the teeth (14B) into the notch (27B), thus attaching the shuttle (14) to the inner rod (24). The end effector (10) is now fully attached in vivo to the shaft (20) and can then be pulled from the tube (41). Because F2 > F1, pulling the shaft (20) proximally will cause the end effector (10) to be pulled out the loader tube (41). The loader (40) can be removed from the surgical field. Operation of the actuator (30) translates to operate the jaws (11), thus enabling a surgeon to manipulate tissue and perform minimally invasive surgical procedures.

    [0019] In vivo detachment is achieved by reversing the attachment steps outlined in the previous paragraph. The loader (40) is introduced into the body cavity and the end effector (10) is slid into the tube (41). The distal end (21) of the outer tube (23) comprises a sloped surface (29). When the slider (25) is advanced distally and compresses the spring (26), the sloped surface (29) also advances distally to engage and laterally spread the shuttle prongs (14A) thus disengaging the teeth (14B) from the notch (27B) on the inner rod (24). The pin (25A) slides in L-shaped slot, enabling the surgeon to keep the sloped surface (29) in its distal-most position. The inner rod (24) can now be pulled from the shuttle (14), effectively making F2 equal to zero (the sloped surfaces (29) may also be used to facilitate in vivo insertion of the inner rod (24) into the shuttle (14)). Because F3 > F2, pulling the shaft (20) proximally will cause the end effector (10) to detach from the inner rod (24) leaving the end effector (10) attached inside the loader tube (41).

    [0020] Having shown and described various embodiments and examples of the present invention, further adaptations of the devices described herein can be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention which is defined by the claims. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the specific materials, dimensions, and the scale of drawings will be understood to be non-limiting examples. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure, materials, or acts shown and described in the specification and drawings.


    Claims

    1. A surgical device, comprising:

    a) an elongate shaft (20) comprising an outer tube (23) and an inner rod (24) positioned in the outer tube (23), the outer tube (23) and inner rod (24) each comprising a distal end (21) and a proximal end (22);

    b) an actuator (30) operably connected to the proximal ends (22) of the outer tube (23) and the inner rod (24);

    c) an end effector (10) adapted for in vivo attachment to and detachment from the elongate shaft (20), the end effector (10) comprising:

    i) an outer casing (12) comprising a first detent mating feature (17) adapted to engage the distal end (22) of the outer tube (23);

    ii) an inner shuttle (14) axially moveable relative the outer casing (12), the shuttle (14) comprising a second detent mating feature adapted to engage the distal end (22) of the inner rod (23), wherein the second detent mating feature comprises a pair of proximally oriented prongs (14A), each having a medially oriented tooth (14B) adapted to engage a notch (27B) on the inner rod (24);

    iii) a pair of surgical jaws (11) having an opened position and closed position dependant on the relative axial position of the shuttle (14) and casing (12);

    d) a tubular loader (40) sized to receive the end effector (10), the tubular loader comprising a third detent mating feature (42) adapted to engage the end effector (10).


     
    2. The surgical device of claim 1, wherein the first (17), second (14A), and third (42) detent mating features have a threshold disengagement force F1, F2, and F3, respectively, of the following relative magnitudes:


     
    3. The surgical device of claim 1, wherein the first detent mating feature (17) comprises a leaf spring on the outer casing (12) adapted to engage a notch (27A) on the outer tube (23).
     
    4. The surgical device of claim 1, wherein the third detent mating feature (42) comprises a leaf spring on the tubular loader (42) adapted to engage a notch (18) on the outer casing (12).
     
    5. The surgical device of claim 1, wherein the distal end (22) of the outer tube (23) comprises a sloped surface (29) adapted to engage and laterally spread the prongs (14A) thereby disengaging the teeth (14B) from the notch (27B) on the inner rod (24).
     
    6. The surgical device of claim 5, further comprising a pusher (25) operably connected to the outer tube (23) to advance the sloped surface (29) distally.
     
    7. The surgical device of claim 6, wherein a pin (25A) connects the outer tube (23) to the pusher (25), and the pin (25A) rides in an L-shaped slot.
     


    Ansprüche

    1. Chirurgische Vorrichtung, umfassend:

    a) einen länglichen Schaft (20), der eine äußere Röhre (23) und einen in der äußeren Röhre (23) positionierten inneren Stab (24) umfasst, wobei die äußere Röhre (23) und der innere Stab (24) jeweils ein distales Ende (21) und ein proximales Ende (22) umfassen,

    b) einen Aktuator (30), der mit den proximalen Enden (22) der äußeren Röhre (23) und dem inneren Stab (24) wirkverbunden ist,

    c) einen Endeffektor (10), der für das In-vivo-Anbringen an dem länglichen Schaft (20) und das In-vivo-Abtrennen von dem länglichen Schaft (20) ausgeführt ist, wobei der Endeffektor (10) Folgendes umfasst:

    i) ein äußeres Gehäuse (12), das ein erstes Rastkoppelmerkmal (17) umfasst, das dazu ausgeführt ist, das distale Ende (22) der äußeren Röhre (23) in Eingriff zu nehmen,

    ii) ein inneres Schiffchen (14), das bezüglich des äußeren Gehäuses (12) axial beweglich ist, wobei das Schiffchen (14) ein zweites Rastkoppelmerkmal umfasst, das dazu ausgeführt ist, das distale Ende (22) des inneren Stabs (23) in Eingriff zu nehmen, wobei das zweite Rastkoppelmerkmal ein Paar proximal ausgerichtete Zinken (14A) umfasst, die jeweils einen medial ausgerichteten Zahn (14B) haben, der zur Ineingriffnahme einer Kerbe (27B) an dem inneren Stab (24) ausgeführt ist,

    iii) ein Paar chirurgische Backen (11) mit einer geöffneten Position und einer geschlossenen Position in Abhängigkeit von der relativen axialen Position des Schiffchens (14) und des Gehäuses (12),

    d) einen röhrenförmigen Lader (40), der zur Aufnahme des Endeffektors (10) bemessen ist, wobei der röhrenförmige Lader ein drittes Rastkoppelmerkmal (42) umfasst, das zur Ineingriffnahme des Endeffektors (10) ausgeführt ist.


     
    2. Chirurgische Vorrichtung nach Anspruch 1, wobei das erste (17), das zweite (14A) und das dritte (42) Rastkoppelmerkmal eine Schwellenausrückkraft F1, F2 bzw. F3 mit der folgenden jeweiligen Größe hat:
    F1 < F3 < F2
     
    3. Chirurgische Vorrichtung nach Anspruch 1, wobei das erste Rastkoppelmerkmal (17) eine Blattfeder an dem äußeren Gehäuse (12) umfasst, die dazu ausgeführt ist, eine Kerbe (27A) an der äußeren Röhre (23) in Eingriff zu nehmen.
     
    4. Chirurgische Vorrichtung nach Anspruch 1, wobei das dritte Rastkoppelmerkmal (42) eine Blattfeder an dem röhrenförmigen Lader (42) umfasst, die dazu ausgeführt ist, eine Kerbe (18) an dem äußeren Gehäuse (12) in Eingriff zu nehmen.
     
    5. Chirurgische Vorrichtung nach Anspruch 1, wobei das distale Ende (22) der äußeren Röhre (23) eine geneigte Fläche (29) umfasst, die dazu ausgeführt ist, die Zinken (14A) in Eingriff zu nehmen und seitlich zu spreizen, wodurch die Zähne (14B) aus der Kerbe (27B) an dem inneren Stab (24) ausgerückt werden.
     
    6. Chirurgische Vorrichtung nach Anspruch 5, ferner umfassend einen Schieber (25), der mit der äußeren Röhre (23) wirkverbunden ist, um die geneigte Fläche (29) distal vorzuschieben.
     
    7. Chirurgische Vorrichtung nach Anspruch 6, wobei ein Stift (25A) die äußere Röhre (23) mit dem Schieber (25) verbindet und der Stift (25A) in einem L-förmigen Schlitz fährt.
     


    Revendications

    1. Dispositif chirurgical, comprenant :

    a) une tige allongée (20) comprenant un tube extérieur (23) et une tige intérieure (24) positionnée dans le tube extérieur (23), le tube extérieur (23) et la tige intérieure (24) comprenant chacun une extrémité distale (21) et une extrémité proximale (22) ;

    b) un actionneur (30) relié fonctionnellement aux extrémités proximales (22) du tube extérieur (23) et de la tige intérieure (24) ;

    c) un effecteur terminal (10) adapté pour la fixation in vivo à la tige allongée (20) et pour le détachement de celle-ci, l'effecteur terminal (10) comprenant :

    i) une enveloppe extérieure (12) comprenant une première entité complémentaire de cran (17) adaptée pour s'engager dans l'extrémité distale (22) du tube extérieur (23) ;

    ii) une navette intérieure (14) mobile axialement par rapport à l'enveloppe extérieure (12), la navette (14) comprenant une deuxième entité complémentaire de cran adaptée pour engager l'extrémité distale (22) de la tige intérieure (23), la deuxième entité complémentaire de cran comprenant une paire de dents (14A) orientées de manière proximale, chacune ayant une dent (14B) orientée médialement adaptée pour engager une encoche (27B) sur la tige intérieure (24) ;

    iii) une paire de mâchoires chirurgicales (11) ayant une position ouverte et une position fermée dépendant de la position axiale relative de la navette (14) et du boîtier (12) ;

    d) un chargeur tubulaire (40) dimensionné pour recevoir l'effecteur terminal (10), le chargeur tubulaire comprenant une troisième entité complémentaire de cran (42) adaptée pour engager l'effecteur terminal (10)


     
    2. Dispositif chirurgical selon la revendication 1, les première (17), deuxième (14A) et troisième (42) entités complémentaires de cran ayant une force de désengagement seuil F1, F2 et F3, respectivement, d'amplitudes relatives suivantes :


     
    3. Dispositif chirurgical selon la revendication 1, la première entité complémentaire de cran (17) comprenant un ressort à lame sur l'enveloppe extérieure (12) adapté pour s'engager dans une encoche (27A) sur le tube extérieur (23).
     
    4. Dispositif chirurgical selon la revendication 1, la troisième entité complémentaire de cran (42) comprenant un ressort à lame sur le chargeur tubulaire (42) adapté pour s'engager dans une encoche (18) sur l'enveloppe extérieure (12).
     
    5. Dispositif chirurgical selon la revendication 1, l'extrémité distale (22) du tube extérieur (23) comprenant une surface inclinée (29) adaptée pour engager et écarter latéralement les dents (14A), désengageant ainsi les dents (14B) de l'encoche (27B) sur la tige intérieure (24).
     
    6. Dispositif chirurgical selon la revendication 5, comprenant en outre un poussoir (25) relié fonctionnellement au tube extérieur (23) pour faire avancer la surface inclinée (29) de manière distale.
     
    7. Dispositif chirurgical selon la revendication 6, une broche (25A) reliant le tube extérieur (23) au poussoir (25), et la broche (25A) se déplaçant dans une fente en forme de L.
     




    Drawing




















    Cited references

    REFERENCES CITED IN THE DESCRIPTION



    This list of references cited by the applicant is for the reader's convenience only. It does not form part of the European patent document. Even though great care has been taken in compiling the references, errors or omissions cannot be excluded and the EPO disclaims all liability in this regard.

    Patent documents cited in the description