BR112018011222B1 - SURGICAL DEVICE - Google Patents

Abstract

DEVICES AND METHODS FOR INCREASE ROTATIONAL TORQUE DURING END ACTUATOR HINGING. Devices and methods are provided for increasing rotational torque during pivoting of an end actuator. In general, a surgical device may include an end actuator configured to pivot. The end actuator can be configured to move between different angular orientations relative to an elongated drive shaft of the device having the end actuator at a distal end thereof. The elongated drive shaft and end actuator can be configured to rotate with respect to a cable portion of the device. The device may include at least one friction member configured to provide increased resistance to rotation of the elongated drive shaft and the end actuator when the end actuator is pivotal compared to when the end actuator is not pivotal. The at least one friction element may thus be configured to increase the rotational torque when the end actuator is pivoted compared to when the end actuator is not pivoted.

Description

FIELD OF THE INVENTION

[001] Devices and methods are provided to increase rotational torque during end actuator articulation.

BACKGROUND

[002] Endoscopic surgical instruments are often preferred over traditional open surgical devices, as an incision, or smaller incisions associated with endoscopic surgical techniques, tend to reduce recovery time and complications in the postoperative period. Consequently, there has been significant development in a variety of endoscopic surgical instruments that are suited to precisely positioning a distal end actuator at a desired surgical site through a cannula of a trocar. These distal end actuators engage tissue in a variety of ways to achieve a diagnostic or therapeutic effect (e.g., endocutters, grippers, cutters, staplers, clip appliers, access device, drug delivery device/gene therapy device, and device). energy using ultrasound, radiofrequency (RF), laser, etc.).

[003] In order to provide better maneuverability and positioning of the end actuator, many surgical devices allow articulation of the end actuator, as well as rotation of the drive shaft that has the end actuator at a distal end thereof. Pivoting and rotating the end actuator can allow the surgeon to reach tissue that would otherwise be inaccessible. In an articulated state, a load on the end actuator creates a moment arm that can cause unwanted rotation of the end actuator.

[004] Consequently, there is a need to increase the rotational torque during articulation of the end actuator.

SUMMARY OF THE INVENTION

[005] In general, devices and methods are provided to increase the rotational torque during the articulation of the end actuator.

[006] In one aspect, a surgical device is provided which, in one embodiment, includes a handle, an elongated drive shaft extending distally from the handle and being configured to rotate with respect to the handle, and an end actuator at a distal end of the elongate drive shaft and having first and second claws configured to engage tissue therebetween. The end actuator is configured to pivot with respect to the elongated drive shaft such that the end actuator is angularly oriented with respect to the elongated drive shaft. When the end actuator is pivoted relative to the elongated drive shaft, the force required to rotate the elongated drive shaft relative to the cable is greater than the force required to rotate the elongated drive shaft relative to the cable when the end actuator is pivoted. end is in a non-pivoting substantially linear orientation with respect to the elongated drive shaft.

[007] The surgical device can vary in any number of ways. For example, the surgical device may include a friction member disposed within the handle and configured to apply an increased frictional force to the elongated drive shaft when the end actuator is pivoted, as compared to when the end actuator is in the orientation. substantially linear non-articulated. Frictional force can be configured to increase in proportion to increasing end actuator linkage, friction member can be configured to deform more and more in proportion to increasing end actuator linkage, friction member can be elastomeric , the surgical device may include an actuator configured to be actuated to cause articulation of the end actuator and actuation of the actuator may also cause compression of the friction member, and/or the surgical device may include an actuator configured to be actuated so as to cause rotation of the elongated drive shaft. In embodiments in which the surgical device includes the actuator, the force required to rotate the elongated drive shaft with respect to the handle when the end actuator is pivoted with respect to the elongated drive shaft can be applied to the actuator, and the force required to rotating the elongated drive shaft with respect to the cable when the end actuator is in a substantially linear orientation not pivoted with respect to the elongated drive shaft can be applied to the actuator such that a greater force is required to be applied to the actuator to rotate the elongated drive shaft when the end actuator is pivoted relative to the elongated drive shaft.

[008] In another example, the surgical device may include a friction member disposed within the handle and configured to resist rotation of the elongated drive shaft when the end actuator is pivoted relative to the elongated drive shaft. The friction member may be configured to not resist rotation of the elongated drive shaft when the end actuator is in the non-pivoting substantially linear orientation, and/or the surgical device may include an actuation mechanism configured to move with respect to the shaft. elongated actuator to cause pivoting of the end actuator, and/or the surgical device may include an actuator configured to be actuated to cause rotational movement of the actuator and thereby cause pivot of the end actuator. In embodiments in which the surgical device includes the actuation mechanism, the friction member may have one or more grooves formed therein which are configured to lock with the actuation mechanism when the end actuator is pivoted with respect to the axis of engagement. elongated drive, and to be unlocked from the actuation mechanism when the end actuator is in non-pivoting substantially linear orientation. In embodiments in which the surgical device includes the actuator, the friction member can be operatively coupled to the actuator such that rotational movement of the actuator causes rotational movement of the engagement mechanism.

[009] In yet another example, the end actuator can be configured to rotate with the drive shaft elongated relative to the cable.

[010] In another embodiment, a surgical device includes an elongated drive shaft having a longitudinal axis, an end actuator at a distal end of the elongated drive shaft, a first actuator configured to be actuated to cause rotation of the elongated drive shaft and the end actuator with respect to the longitudinal axis of the elongated drive shaft, a second actuator configured to be actuated to angularly adjust the end actuator with respect to the longitudinal axis of the elongated drive shaft, and a friction member configured to adjust an amount of force required to be applied to the first actuator to cause rotation of the elongated drive shaft and the end actuator based on an angle of the end actuator relative to the longitudinal axis of the elongated drive shaft. The end actuator is configured to manipulate tissue while performing a surgical procedure.

[011] The surgical device can have any number of variations. For example, the greater the angle of the end actuator relative to the longitudinal axis of the elongated drive shaft, the greater the amount of force the friction member can require to be applied to the first actuator to cause the elongated drive shaft to rotate. and the end actuator. In another example, the friction member may include a clutch mechanism configured to increasingly deform in shape the greater the angle of the end actuator relative to the longitudinal axis of the elongated drive shaft, and the amount of force may correspond to a degree of deformation of the coupling mechanism's shape. In yet another example, the friction member can include a clutch mechanism configured to move between a locked configuration and an unlocked configuration based on the angle of the end actuator relative to the longitudinal axis of the elongated drive shaft, and the amount of force can correspond to whether the engagement mechanism is in the locked configuration or in the unlocked configuration. In yet another example, the surgical device may include a handle, the elongated drive shaft may extend distally from the handle, and the friction member may be disposed within the handle.

[012] In another aspect, a method for treating tissue is provided which, in one embodiment, includes applying a first force to a first actuator on a cable of a device to rotate an elongated drive shaft of the device relative to the cable, actuating a second actuator on the handle so as to cause an end actuator at a distal end of the elongated drive shaft to pivot relative to the elongated drive shaft, and manipulating the device to cause the end actuator to act on the tissue . With the end actuator pivoted relative to the elongated drive shaft, the elongated drive shaft is prevented from rotating relative to the cable until a second force greater than the first force is applied to the first actuator.

[013] The method can have any number of variations. For example, the first force can be applied to the first actuator with the end actuator not being pivoted with respect to the elongated drive shaft. In another example, the first actuator can include a rotation knob, the first force can include a first rotational force that rotates the rotation knob, the second actuator can include a pivot knob, and actuating the second actuator can include rotating the knob. of articulation.

BRIEF DESCRIPTION OF THE DRAWINGS

[014] The embodiments described below can be understood more fully from the detailed description below taken in conjunction with the attached drawings. Drawings are not intended to be made to scale. For the sake of clarity, not all components can be identified on each drawing. In the drawings:

[015] Figure 1 is a side view of an embodiment of a surgical device;

[016] Figure 2 is a perspective view of the device of Figure 1;

[017] Figure 3 is a perspective view of a distal portion of the device of Figure 1 with selected elements of the device omitted for purposes of clarity of illustration;

[018] Figure 4 is a cross-sectional perspective view of a portion of the cable portion of the device of Figure 1;

[019] Figure 5 is a side cross-sectional view of another portion of the cable portion of the device of Figure 1;

[020] Figure 6 is a perspective view of a portion of the cable portion of the device of Figure 1 with selected elements of the device omitted for purposes of clarity of illustration;

[021] Figure 7 is another perspective view of a portion of the cable portion of the device of Figure 1 with selected elements of the device omitted for purposes of clarity of illustration;

[022] Figure 8 is a perspective view of a connecting rod of the device of Figure 1;

[023] Figure 9 is a side view of the cross section of an actuator of the device of Figure 1;

[024] Figure 10 is a perspective view of a barrel of the device of Figure 1;

[025] Figure 11 is a side view of the drum of Figure 10;

[026] Figure 12 is an end view of the drum of Figure 10;

[027] Figure 13 is another perspective view of a portion of the cable portion of the device of Figure 1 with selected elements of the device omitted for purposes of clarity of illustration;

[028] Figure 14 is a perspective view of a friction member of the device of Figure 1;

[029] Figure 15 is another perspective view of the friction member of Figure 14;

[030] Figure 16 is a perspective view of another embodiment of a friction member engaged with the drum of Figure 10;

[031] Figure 17 is a perspective view of yet another embodiment of a friction member engaged with the drum of Figure 10;

[032] Figure 18 is a partially transparent, partially transverse, perspective view of a portion of another embodiment of a surgical device;

[033] Figure 19 is a perspective view partially in cross-section, partially transparent of a cable portion of the device of Figure 18;

[034] Figure 20 is another perspective view partially in cross-section, partially transparent of the cable portion of Figure 19;

[035] Figure 21 is a cross-sectional view of the end of the device of Figure 18 with an actuator thereof in a first position;

[036] Figure 22 is a cross-sectional view of the end of the device of Figure 21 with the actuator in a second position;

[037] Figure 23 is a partially transparent perspective view of a portion of another embodiment of a surgical device;

[038] Figure 24 is a cross-sectional view of a portion of the device of Figure 23;

[039] Figure 25 is a partially transparent, partially transverse perspective view of another embodiment of a surgical device; It is

[040] Figure 26 is a graph showing the test results for the device in Figure 23.

DETAILED DESCRIPTION

[041] Certain exemplary embodiments will now be described to provide a general understanding of the principles of structure, function, fabrication and use of the devices and methods disclosed herein. One or more examples of such embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described in the present invention and illustrated in the accompanying drawings are non-limiting exemplary embodiments, and that the scope of the present invention is defined only by the embodiments. Features illustrated or described in relation to an exemplary embodiment may be combined with features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.

[042] Additionally, in the present disclosure, components with the same names as the embodiments have, in general, similar features, and thus, in a particular embodiment, each feature of each component with the same names is not necessarily fully elaborated on that. Additionally, to the extent that linear or circular measurements are used in describing the systems, devices and methods presented, such dimensions are not intended to limit the types of formats that may be used in conjunction with such systems, devices and methods. One skilled in the art will recognize that an equivalent of such linear and circular dimensions can easily be determined for any geometric shape. Sizes and shapes of the systems and devices, and the components thereof, may depend at least on the anatomy of the individual with which the systems and devices will be used, the size and shape of components with which the systems and devices will be used, and the methods and procedures in which the systems and devices will be used.

[043] Devices and methods to increase rotational torque during end actuator articulation are provided. In general, a surgical device may include an end actuator configured to pivot. The end actuator can be configured to move between different angular orientations relative to an elongated drive shaft of the device having the end actuator at a distal end thereof. The elongated drive shaft and end actuator can be configured to rotate with respect to a portion of the device handle. The device may include at least one friction member configured to provide increased resistance to rotation of the elongated drive shaft and the end actuator when the end actuator is pivotal compared to when the end actuator is not pivotal. The at least one friction member can thus be configured to increase the rotational torque when the end actuator is pivoted compared to when the end actuator is not pivoted. In other words, the at least one friction member can be configured to increase an amount of force required to rotate the elongated drive shaft and end actuator, i.e., an amount of force required to be applied by a user to the device. to cause the elongated drive shaft and end actuator to rotate when the end actuator is pivoted compared to when the end actuator is not pivoted. The end actuator can therefore be less susceptible to involuntary rotation when pivoted, since a greater rotational torque force must be applied to the device to cause the elongated drive shaft and end actuator to rotate when the end actuator is pivoted. The end actuator is pivoted compared to when the end actuator is non-articulated, which may allow for more precise control of the end actuator position while performing a surgical procedure and thereby assist the end actuator in manipulating tissue. as intended without losing adherence over the tissue and/or without damaging any adjacent tissue or any other adjacent structures.

[044] Figure 1 illustrates an embodiment of a surgical device 2 that may include a proximal handle portion 4 having a drive shaft assembly 6 extending distally therefrom. As also shown in Figures 2 and 3, the device 2 can include a working element 8, also called in the present invention an "end actuator", coupled to a distal end of the drive shaft assembly 6. The end actuator 8 can be coupled to the driveshaft assembly 6 on a pivot joint 10. A proximal end of the end actuator 8 can be pivotally coupled to the joint 10 at the distal end of the driveshaft assembly 6.

[045] End actuator 8 can have a variety of sizes, shapes and configurations. As shown in Figures 1 to 3, the end actuator 8, which includes the first and second claws 12a, 12b, can be arranged at a distal end of the surgical device 2. The end actuator 8, in this illustrated embodiment, includes a tissue gripper, having a pair of opposing jaws 12a, 12b, configured to move between the open and closed position. End actuator 8 can have other configurations, for example scissors, a babcock forceps, a retractor, etc. In an exemplary embodiment, the end actuator 8 may be rigid. End actuator 8 may include top, or first, top jaw 12a and bottom, or second, bottom jaw, 12b, pivotally connected to each other at pivot joint 10.

[046] One or both of the claws 12a, 12b may include electrodes 24 on their tissue-engaging surfaces. Electrodes 24 can be configured to contact tissue positioned between jaws 12a and 12b and to apply energy thereto. The electrodes 24 of this illustrated embodiment include a U-shaped electrode on the lower jaw 12b and a corresponding U-shaped electrode (obscured in the Figures) on the upper jaw 12a, but the electrodes 24 can be arranged in a variety of ways on the upper jaw 12a and /or in the bottom jaw 12b. The electrodes 24 of the device 2 can be, in general, configured and used similarly to the electrodes described in the US patent application No. 14/658,944, entitled "Methods and Devices for Actuating Surgical Instruments", filed on March 16, 2015 , which is incorporated herein by reference in its entirety.

[047] The cable portion 4 can have a variety of sizes, shapes and configurations. The cable portion 4 can include a main compartment 32, which can house a variety of elements in it and can have some elements accessible from the outside thereof, such as a first actuator 13, a second actuator 14, a third actuator 16 and a fourth actuator 18.

[048] The first actuator 13 can be configured to act on the opening and closing of the opposing claws 12a, 12b, that is, on the movement of the claws 12a, 12b towards each other and in the opposite direction. Jaws 12a and 12b in Figures 1 to 3 are shown in the open position. As in this illustrated embodiment, the upper jaw 12a can be configured to move in relation to the lower jaw 12b, which can remain stationary in relation to the drive shaft assembly 6, to act in the opening and closing of the end actuator 8. modalities, in order to affect the opening and closing of the end actuator, the lower jaw can be configured to move relative to the upper jaw, or both the upper and lower jaws can be configured to move relative to the drive shaft assembly. drive.

[049] The first actuator 13 can be configured to move a cutting element (obscured in the Figures) (for example, a knife, a blade, etc.) along the end actuator 8. The cutting element can be configured to cut the tissue positioned between the grips 12a and 12b, as will be understood by one skilled in the art. As shown in Figure 3, the jaws 12a, 12b may include an elongated slit 28 in the tissue engaging surfaces thereof (the slit in the upper jaw 12a is obscured in Figure 3) through which the cutting element may be configured to slide .

[050] In an exemplary embodiment, the first actuator 13 may include a clamp arm, also called in the present invention a "closing trigger", and a "mobile cable". The closing trigger 13 can, in other embodiments, have different sizes, shapes and configurations, for example, without thumb rests, multiple finger loops, different arched shapes, etc. As in this illustrated embodiment, the closing trigger 13 can be pivotally attached to the main compartment 32. The closing trigger 13 can be configured to move towards and away from the main compartment 32, thereby causing the opening and closing of the compartment. end actuator 8 as discussed further below.

[051] The second actuator 14 can be configured to act on the joint of the end actuator 8, for example, on the movement of both claws 12a, 12b in the same direction with respect to a longitudinal axis A of the drive shaft assembly 6 The articulation can be independent of the opening and closing of the claws 12a and 12b. The end actuator 8 is shown in Figures 1 to 3 in an unhinged position, for example at a substantially zero angle with respect to the longitudinal axis A so as to be in a substantially linear orientation along the longitudinal axis A One skilled in the art will understand that the end actuator 8 may not be at precisely zero angle with respect to the longitudinal axis A of the drive shaft assembly 6, but it will still be considered to be substantially zero with respect to the axis longitudinal A of the driveshaft assembly 6 due to any one or more factors such as manufacturing tolerance and sensitivity of the angle measuring devices. The second actuator 14 can be operatively connected to a drive mechanism, which can be disposed within the main compartment 32 and is discussed further below, so that the actuation of the second actuator 14, i.e. the manual movement thereof by a user, could cause the end actuator 8 to pivot. In an exemplary embodiment, the second actuator 14 can be configured to be actuated to cause the jaws 12a and 12b to pivot in opposite directions D1 and D2 (shown in Fig. Figure 3) in relation to the longitudinal geometric axis A.

[052] The second actuator 14 can have a variety of sizes, shapes and configurations. As in this illustrated embodiment, the second actuator 14 can include a rotary knob. Rotation of the second actuator 14 in one direction (e.g. clockwise) can be configured to cause end actuator 8 to pivot in the first D1 direction (e.g. right) and rotation of the second actuator 14 in the opposite direction ( counterclockwise, for example) can be configured to cause end actuator 8 to pivot in the second direction, during the second D2 direction (for example, left). The button 14 can be rigid, i.e. it can be formed from a rigid material. Button 14 may include a movable ring, as shown in Figure 5. Button 14 may include one or more finger depressions on the outer surface thereof, as illustrated in this embodiment. The finger depressions can facilitate manual movement of the knob 14 using one or more fingers located in the finger depressions. As in this illustrated embodiment, the finger depressions may extend around the entire circumference of the outer surface of the button.

[053] The third actuator 16 can be configured to rotate the drive shaft assembly 6 and the end actuator 8 around the longitudinal axis A of the drive shaft assembly 6. In the illustrated embodiment, the third actuator 16 includes a rotary knob that can be rotated about the longitudinal axis A, but the third actuator 16 can have a variety of other configurations, for example a lever, a button, a movable handle, etc. As in the illustrated embodiment, the third actuator 16 can be configured to continuously and repeatedly rotate the drive shaft assembly 6 and end actuator 8 through 360°, either clockwise or counterclockwise. In other words, driveshaft assembly 6 can be configured for unlimited bi-directional rotation. As will be appreciated by one skilled in the art, the drive shaft assembly 6 and end actuator 8 can be rotated less than 360° as desired during the performance of a surgical procedure (e.g., rotated 20°, rotated 90° , rotated 150°, etc.) and can be rotated more than 360° as desired while performing a surgical procedure (eg, rotated 450°, rotated 480°, rotated 720°, etc.).

[054] As in the illustrated embodiment, the surgical device 2 can be powered and configured as an electrosurgical tool configured to apply energy to tissue, such as radiofrequency (RF) energy. The cord portion 4 may have a power cord (not shown) extending proximally therefrom which may be configured to supply electrical power to the device 2, such as by connecting to a generator, plugging into an electrical outlet, etc. In other embodiments, the surgical device may be de-energized, i.e., not configured to deliver energy to tissue.

[055] The fourth actuator 18 can be configured to turn on and off the application of energy that can be applied to the tissue through the electrodes 24. In the illustrated embodiment, the fourth actuator 18 includes a button, but the fourth actuator 18 can have other configurations , for example, a button, a lever, a movable cable, a switch, etc. In other embodiments, the fourth actuator 18, instead of the first actuator 13, can be configured to translate the cutting element.

[056] The drive shaft assembly 6 can have a variety of sizes, shapes and configurations. The drive shaft assembly 6 can be of any longitudinal length, although in an exemplary embodiment it can be long enough to allow the cable portion 4 to be manipulated outside the patient's body while the drive shaft assembly 6 extends through an opening in the body with the end actuator 8 disposed within the body cavity, i.e. having a longitudinal length in the range of about 25 to 50 cm, with a longitudinal length of about 33 cm. In this way, the end actuator 8 can be easily manipulated when the device 2 is in use during a surgical procedure. The driveshaft assembly 6 can be of any diameter. For example, the diameter of the drive shaft assembly can be less than or equal to about 15 mm, for example less than or equal to about 10 mm, less than or equal to about 7 mm, less than or equal to about 5 mm, etc., which may allow insertion of the driveshaft assembly 6 through a minimally invasive access device, such as during a laparoscopic surgical procedure. The end actuator 8 coupled to the distal end of the drive shaft assembly can have a diameter equal to or less than the diameter of the drive shaft assembly, at least when the jaws 12a, 12b are in the closed position, which can facilitate insertion of the distal portion of the device into a patient's body.

[057] As in the illustrated embodiment, the drive shaft assembly 6 may include an elongated outer drive shaft 34 (also called "outer housing" herein) and at least one actuation shaft extending between the cable portion 4 and the end actuator 8. The one or more actuation shafts can be configured to facilitate the articulation of the end actuator 8, in order to facilitate the opening/closing of the end actuator 8 and/or to facilitate the movement of the control element. cut along the end actuator 8. As in this illustrated embodiment, shown in Figure 3, the device 2 can include a first and second actuation axis 26a, 26b configured to facilitate the articulation of the end actuator 8, and a third axis of drive 26c configured to facilitate movement of the cutting element 26 along the end actuator 8. In other embodiments, a surgical device may include any combination of actuation axes configured to facilitate articulation of the end actuator and movement of the end actuator. cut along the end actuator, i.e. only include the first and second actuation axes; include only the third axis of action; include the first, second and third lines of action; etc. The actuation shafts can each have relatively small diameters, which can facilitate their inclusion in a device configured for use in a minimally invasive surgical procedure.

[058] The first, second and third actuation axes 26a, 26b and 26c can each have a variety of configurations. As illustrated in this embodiment, each of the actuation shafts 26a, 26b and 26c may include an elongated flat element. Examples of actuation axes are further described in US patent application No. 14/658,944 entitled "Methods and Devices for Actuating Surgical Instruments", filed on March 16, 2015.

[059] The first and second actuation axes 26a, 26b can be operatively connected to the second actuator 14 of the device to facilitate articulation of the end actuator 8. The first and second actuation axes 26a, 26b can be operatively connected operational to the second actuator 14 of the device in several ways. As shown in this embodiment illustrated by Figures 4 to 7, and as discussed further below, device 2 may include first and second nuts 44a, 44b and first and second connecting rods 22a and 22b. The second actuation shaft 22b is also shown as a stand-alone element in Figure 8. The first nut 44a and the first connecting rod 22a can be configured to operatively couple the first actuation shaft 26a to the second actuator 14, and the second nut 44b and second connecting rod 22b may be configured to operatively couple second actuation shaft 22b to second actuator 14.

[060] The third actuation axis 26c can be operatively connected to the fourth actuator 18 of the device to facilitate the movement of the cutting element through the end actuator 8. The third actuation axis 26c can be operatively connected to the first actuator 13 so that actuation of the first actuator 13 can be configured to cause movement of the third actuation axis 26c and thus move the cutting member along the end actuator 8 and cause the jaws 12a, 12b to close (i.e. end actuator 8 moves to a closed position). The third actuation shaft 26c may have a compression element 30 (see Figure 3) coupled to a distal end thereof. The compression element 30 may have the cutting element at a distal end thereof, as in this illustrated embodiment. The compression element 30 can be configured to translate along the end actuator 8 in opposing channels (concealed in the Figures) formed in the first and second jaws 12a, 12b to cause the jaws 12a, 12b to close as the element cutting edge on the compression element 30 translated along the end actuator 8. Examples of compression elements are described in more detail in US Patent Publication No. 2015/0209059 entitled "Methods And Devices For Controlling Motorized Surgical Devices", filed in January 28, 2014, which is incorporated herein by reference in its entirety, and in U.S. Patent Publication No. 2012/0078247, entitled "Articulation Joint Features For Articulating Surgical Device", filed on September 19, 2011.

[061] The third actuation shaft 26c can be operatively connected to the first actuator 13 in several ways. As in the illustrated embodiment, as shown in Figures 4 to 6, the first actuator 13 can be operatively coupled to a closing mechanism 36 through a lever 38. The movement of the first actuator 13 towards the compartment 32, for example , toward a stationary handle 15 (see Figures 1 and 2) thereof, can be configured to cause pivotal movement of lever 38, which can be configured to cause closing mechanism 36 to move in a distal direction. Third actuation axis 26c can be fixedly coupled to closure mechanism 36, as shown in Figures 4 and 5, such that distal movement of closure mechanism 36 causes distal movement of third actuation axis 26c and element of compression 30 coupled thereto, thus causing the closing of the end actuator 8 and the distal movement of the cutting element along the end actuator 8. Likewise, the movement of the closing trigger 13 away from the compartment 32, by For example, in the opposite direction to the stationary cable 15, could cause proximal movement of the closing mechanism 36 and thus cause the end actuator 8 to open and the cutting element to move proximally along the end actuator 8.

[062] In other embodiments, instead of the first actuator 13 being configured to cause the translation of the cutting element and the closing of the end actuator 8, the device 2 may include an actuator (for example, the first actuator 13) configured to actuating end actuator 8 and another actuator (for example, a fifth actuator, not shown) configured to cause movement of the cutting element to close.

[063] The fourth actuator 18 can be operatively connected to a conductive conductor 20 (shown in Figures 4 and 5), which in this illustrated embodiment includes an RF cable configured to be in electrical communication with the power cable and with the electrodes 24. The actuation of the fourth actuator 18, for example pushing the button, can be configured to close a circuit and thus allow energy to be supplied to the RF cable 20, which may consequently allow energy to is supplied to electrodes 24.

[064] The device 2 can include a flexion region 41 configured to facilitate the articulation of the end actuator 8. The flexion region can include a flexible outer casing 43, shown in Figure 2. The flexible outer casing 43 can, as a flexible element, be configured to flex or bend without cracking, tearing, or otherwise being damaged, which can facilitate articulation of the end actuator 8. The flexible outer housing 43 may have an inner lumen extending through the itself, an upper column extending longitudinally therealong, a lower column extending longitudinally therealong, and a plurality of spaced ribs extending between the upper and lower columns on either side (e.g., the sides left and right) of the flexible outer housing 43. The first, second and third actuation shafts 26a, 26b and 26c and the RF cable 20 can each extend through the inner lumen of the flexible outer housing 43. Embodiments Examples of flexible outer housings are further described in US Patent Publication No. 2012/0078247, entitled "Articulation Joint Features For Articulating Surgical Device", filed on September 19, 2011, and US Patent Application No. 14/659,037 entitled "Flexible Neck For Surgical Instruments", filed March 16, 2015, which are incorporated herein, by reference, in their entirety.

[065] As mentioned above, the second actuator 14 can be configured to facilitate the articulation of the end actuator 8, which also as mentioned above, can include the inclination or flexion of the flexible outer housing 43. The actuation mechanism connected in such a way operational to the second actuator 14 can have a variety of sizes, shapes and configurations. As in this illustrated embodiment, the actuation mechanism can be coupled to the proximal portion of the cable 4 of the device 2 and can include the second actuator 14, which, as described in the present invention, can be configured to be activated manually by a user to act on the end actuator pivot 8. Figure 9 illustrates the second actuator 14 as a self contained element in cross section. As in this illustrated embodiment, the second actuator 14 may include a ring-shaped portion configured to be accessible to a user outside the main compartment 32 and may include an elongated tubular portion extending proximally from the ring-shaped portion and being configured to be contained within the main compartment 32. The second actuator 14 can thus be cannulated.

[066] The second actuator 14 may include first and second threads 42a, 42b formed on an inner surface 14i thereof. The first thread 42a can be associated with the first actuation axis 26a and the second thread 42b can be associated with the second actuation axis 26b, as discussed further below. The first and second threads 42a and 42b may be independent of each other, as in this illustrated embodiment, with each of the first and second threads 42a and 42b defining separate paths. The first and second threads 42a and 42b can wrap in opposite directions around the second actuator 14, i.e., one in the left direction and one in the right direction. The first and second threads 42a and 42b can be of any length around the inner surface 14i of the second actuator. In an exemplary embodiment, the first and second threads 42a and 42b can be the same length around the inner surface of the second actuator 14i, which can facilitate symmetrical articulation of the end actuator 8. The first and second threads 42a and 42b in this embodiment illustrated include slots configured to mate with corresponding protrusions configured to slide within the slots. In other embodiments, the first and second threads 42a and 42b of the second actuator 14 may include protrusions configured to slidably engage with corresponding grooves.

[067] The drive mechanism may include the first and second nuts 44a, 44b, also called "drums" in the present invention, configured to moveably fit the second actuator 14. The first and second drums 44a, 44b may have a variety of sizes, shapes and configurations. The first nut 44a can be associated with the first actuation shaft 26a and the second nut 44b can be associated with the second actuation shaft 26b, as discussed further below. As in this illustrated embodiment, each of the first and second drums 44a and 44b can be generally cylindrical in shape and can be cannulated. The first and second barrels 44a and 44b can be configured to be disposed within the cannulated interior of the second actuator 14, as illustrated in Figures 4 through 7 (the first barrel 44a is omitted from Figure 7 for clarity of illustration). Figures 10 to 12 illustrate the first drum 44a as an autonomous element.

[068] The first barrel 44a may include a third thread 46a on an outer surface thereof that may be configured to threadably engage with the first thread 42a of the second actuator 14, and the second barrel 44b may include a fourth thread 46b on an outer surface thereof which may be configured to threadably engage with the second thread 42b of the second actuator 14. The third and fourth threads 46a and 46b may be independent of one another, as in this illustrated embodiment, with each of the third and fourth threads 46a and 46b defining separate paths. The third and fourth threads 46a and 46b can wrap in opposite directions around their respective barrels 44a and 44b, for example, one in the left direction and one in the right direction, thus facilitating their engagement with the first and second opposite threads in the left and right 42a and 42b. The third and fourth threads 46a and 46b can be any length around their respective outer surfaces of barrels 44c, 44d. In an exemplary embodiment, the third and fourth threads 46a and 46b can be the same length around their respective outer surfaces of barrels, which can facilitate symmetrical articulation of the end actuator 8. The third and fourth threads 46a and 46b in this illustrated embodiment include protrusions configured to slideably engage with corresponding grooves (e.g., the grooves 42a and 42b), but in other embodiments, the third and fourth threads 46a and 46b may include grooves configured to slidably engage with protrusions correspondents.

[069] In response to actuation of the second actuator 14, for example, in response to rotation by the user of the second actuator 12, the second actuator 14 can be configured to rotate around a longitudinal axis A2 (shown in Figure 9) in the same. As in this illustrated embodiment, the second longitudinal axis of the actuator A2 may be coaxial with the longitudinal axis of the drive shaft assembly A. The second actuator 14 may be configured to remain stationary along its longitudinal axis A2 during rotation. In other words, the second actuator 14 can be configured not to move distally or proximally during its rotation. Rotation of the second actuator 14 can cause the first and second barrels 44a and 44b to be disposed within the second actuator 14 and threadably engaged therewith (for example, the first thread 42a threadably engaged with the third thread 46a and the second thread 42b threadably engaged with the fourth thread 46b) move simultaneously. Opposite threading of the first and second threads 42a and 42b, and their corresponding third and fourth threads 46a, 46b of the first and second barrels 44a and 44b, can cause the first and second barrels 44a and 44b to move in opposite directions . One of the first and second drums 44a and 44b can move proximally, and the other of the first and second drums 44a and 44b can move distally. Movement of the first and second drums 44a and 44b may include longitudinal translation along the longitudinal axis A2 of the second actuator, which, as in this illustrated embodiment, may also be along the longitudinal axis A of the drive shaft assembly. The first and second drums 44a and 44b can be configured to alternately move distally and proximally during actuation of the second actuator 14. In other words, rotation of the second actuator 14 in the same direction, either clockwise or counterclockwise clockwise, you can first move the first drum 44a distally and the second drum 44b move proximally, and then cause the first and second drums 44a and 44b to alternate directions so that the first drum 44a moves proximally and the second drum 44b moves distally. The first actuator shaft 26a may be operably connected to the first drum 44a, as discussed herein, such that movement of the first drum 44a may cause a force to be applied to the first actuator shaft 26a and then cause corresponding movement of the first actuator shaft 26a. Actuator shaft 26a, for example, longitudinal translation of the first drum 44a in a proximal direction can cause longitudinal translation of the first actuator shaft 26a in the proximal direction. The second actuator shaft 26b can be operatively connected to the second drum 44b, as discussed herein, such that movement of the second drum 44b can cause a force to be applied to the second actuator shaft 26b and then cause corresponding movement of the second actuator shaft 26b, for example, longitudinal translation of the second drum 44b in a distal direction can cause longitudinal translation of the second actuator shaft 26b in the distal direction. The movement of the first and second drive shafts 26a, 26b can be configured to cause the end actuator 8 to pivot. Examples of end actuator articulation utilizing movable barrels are further described in US Patent Application No. 14/658,944 entitled "Methods and Devices for Actuating Surgical Instruments", filed March 16, 2015.

[070] The first actuation shaft 26a can be operatively connected to the first drum 44a and the second actuation shaft 26b can be operatively connected to the second drum 44b in various ways. As in this illustrated embodiment, the device 2 can include the first connection rod 22a configured to couple the first actuation axis 26a to the first drum 44a, and can include the second connection rod 22b configured to couple the second actuation axis 26b to the second drum 44b. As shown in Figures 6 to 8, the second connecting rod 22b may include a first engagement element 21 configured to mate with a corresponding engagement feature 21b of the second actuation shaft 26b. The first socket 21 includes a protrusion and the socket 21b includes a hole in this illustrated embodiment, but the first socket 21 and its corresponding socket 21b may have other configurations, for example, the first socket including a hole and a socket feature including a protrusion, one of the first socket element and the socket feature including a female connector and the other of the first socket element and the socket feature including a male connector, etc. The second connecting rod 22b may include a second engagement member 23 configured to mate with the second barrel 44b. The second locking element 23 in this illustrated embodiment includes a longitudinal cutout. The cutout 23 may have a length 23L greater than a width of an inside diameter of the second drum 44b, thus allowing the second connecting rod 22b to extend through an inner passageway of the second drum 44b with the second drum 44b seated in the second engagement member of the second connecting rod 23, as shown in Figures 6 and 7. The first connecting rod 22a can similarly couple the first actuation shaft 26a to the first drum 44a with the first actuation shaft 26a extending through an internal passage 44i of the first drum 44a, for example, a third coupling element (obscured in the figures) of the first connecting rod 22a can be fitted to the corresponding coupling element (obscured in the figures) of the first actuation axis 26a and a fourth engagement element (obscured in the figures) of the first connecting rod 22a can be engaged with the first drum 44a.

[071] The device 2 may include a first and a second friction member 40a, 40b, as shown in Figures 4 to 6 and 13 (the first friction member 40a is omitted from Figure 6 for clarity of illustration). Figures 14 and 15 illustrate the second friction member 40b as a self-contained element. The first and second friction members 40a and 40b can be configured to provide increased resistance to rotation of the drive shaft assembly 6 and the end actuator 8 attached thereto when the end actuator 8 is pivoted compared to when the actuator is pivoted. end cap 8 is not hinged. The first and second friction members 40a and 40b can thus be configured to increase the rotational torque when the end actuator 8 is pivoted, i.e. it is in the pivoted position, compared to when the end actuator 8 is not. articulated, that is, it is in the non-articulated position. In other words, the first and second friction members 40a and 40b can be configured to increase an amount of force required to rotate the drive shaft assembly 6 and the end actuator 8 attached thereto, when the end actuator 8 is pivoted compared to when the end actuator 8 is not pivoted. As mentioned above, the end actuator 8 may therefore be less susceptible to involuntary rotation when pivoted, as a greater rotational torque force must be applied to the third actuator 18 to cause rotation of the drive shaft assembly 6 and end actuator 8 when the end actuator 8 is hinged compared to when the end actuator 8 is not hinged, which may allow for more precise control of the position of the end actuator while performing a surgical procedure, and thereby thereby assisting the end actuator to manipulate the tissue as intended without losing grip on the tissue and/or without damaging any adjacent tissue or any other adjacent structures.

[072] The first and second friction members 40a and 40b can have a variety of configurations. As shown in Figures 4 to 6 and 13 to 15, the second friction member 40b may include a generally cylindrical member having an internal passage 40i extending therethrough. An outer surface of the second friction member 40b may include a channel 40c formed therein around a circumference thereof. Channel 40c can be configured to seat the second drum 44b therein. A distal face 40d, for example a distally facing edge, of the second friction member 40b may include a plurality of grooves 40g formed therein. Second friction member 40b includes five grooves 40g in this illustrated embodiment, but may include any other number of grooves. In an exemplary embodiment, the slots 40g may be spaced equidistantly around the circumference of the friction member, as in this illustrated embodiment in which the slots 40g are located at 0°, 72°, 144°, 216° and 288° radially around the distal surface 40d. Each of the slots 40b is rectangular in shape in this illustrated embodiment, but the slots 40b can be shaped differently. Each of the grooves 40g illustrated in this embodiment extends over a full width of the distal face of the friction member 40d, which can facilitate secure seating of the second connecting rod 22b therein.

[073] The second friction member 40b can be configured to be seated with the inner passage of the second drum 44b, so that the second actuation rod 26b can extend through the inner passage of the second barrel 44b and the inner passage 40i of the second friction member 40b. Each of the slots 40g can be configured to seat therein, the second connecting bar 22b (e.g. a support 23s thereof) coupled to the second barrel 44b through which the second connecting bar 22b can also extend. A width 40w of each of the slots 40g may be greater than a depth 23d of the support 23s (see Figures 8 and 14) of the second connecting bar 22b configured to be alternately seated and unseated in a slot 40g. The second connection bar 22b can thus be configured to be fully seated in one of the slots 40g.

[074] The fact that one of the grooves 40g seats the second connection bar 22b at least partially in the same or none of the grooves 40g seats the second connection bar 22b at least partially in it, may depend on an amount of the actuator linkage of far end. When the end actuator 8 is not pivoted, none of the slots 40g can seat the second connection bar 22b therein. The amount of rotational torque required to rotate the drive shaft assembly 6 and end actuator 8, for example, an amount of rotational torque required to be applied to the third actuator 16 (for example, an amount of hand force applied to this by a user), can therefore be at its minimum. The drive shaft assembly 6 and the end actuator 8 can thus be easily rotated through the actuation of the third actuator 16. When the end actuator 8 is in the pivoted position, one of the slots 40g can seat the second drive bar. connection 22b at least partially therein. The amount of rotational torque required to rotate the drive shaft assembly 6 and end actuator 8 can therefore be greater than when end actuator 8 is not pivoted, provided that the groove 40g in which the second rod connector 22b is at least partially seated, can provide resistance to the rotational force. When the end actuator 8 is pivoted at a non-zero angle that is less than a maximum pivot angle of the end actuator 8, one of the slots 40g can seat the second connecting rod 22b partially therein. The more the end actuator 8 is pivoted, for example the greater the non-zero angle, the more the second connecting rod 22b is seated in the groove 40g and thus the greater the resistance that the second friction member 40b provides to the rotation. When the end actuator 8 is pivoted at a non-zero angle which is the maximum pivot angle of the end actuator 8, one of the slots 40g can seat the second connecting bar 22b completely therein. Second friction member 40b can thus be configured to provide maximum resistance to rotation when end actuator 8 is fully pivoted. In this way, the rotational torque required to rotate the driveshaft assembly 6 and end actuator 8 can increase in proportion to the amount of end actuator pivot.

[075] As shown in Figures 4, 6 and 15, a proximal face 40p, for example a proximally facing edge, of the second friction member 40b may be free of grooves. In other embodiments, the proximal face of the friction member can include a plurality of grooves formed therein and the distal face of the second friction member can be free of grooves, or each of the proximal and distal faces of the friction member can include a groove. plurality of grooves. In embodiments in which both the proximal and distal faces include a plurality of grooves, the plurality of grooves on the proximal and distal faces may be the same and the grooves may be radially aligned around the circumference of the friction member (e.g., placed at 0°, 60°, 120°, 180°, 240° and 300° around the circumference on each of the proximal and distal faces) to facilitate the simultaneous seating of the second connection bar 22b in a groove on each of the faces, so that frictional forces are balanced on the faces.

[076] The first friction member 40a can be configured similarly to the second friction member 40b, for example, it can have an internal passageway extending therethrough, it can be configured to rest in a first internal passageway 44i of the first barrel 44a, may include a circumferential channel 40h (see Figure 4) configured to seat the first barrel 44a therein, and may have a plurality of grooves 40r formed therein (in this illustrated embodiment, only on the distal face of the first barrel member 44a). friction) (two of the slots are obscured in Figure 13) configured to seat the first connecting bar 22a thereon based on an end actuator linkage quantity. Various grooves 40r, 40g on the first and second friction members 40a, 40b may be matched and the grooves 40r, 40g may be radially aligned around the circumferences of the second friction member to facilitate simultaneous seating (partial or full) of the first and second friction members. of the second connecting rods 22a and 22b into their respective associated grooves 40r, 40g, so that the frictional forces are balanced.

[077] Figure 16 illustrates another embodiment of a friction member 48 that includes a plurality of grooves 48g, eight in that illustrated embodiment. The friction member 48 is shown, in this illustrated embodiment, positioned within the first drum 44a, but the friction member 48 may be coupled with other types of drums. Slots 48g in this illustrated embodiment are each rectangular in shape and each extends over a full width of the proximal face of friction member 48p. As mentioned above, friction member 48 may also include grooves on a distal face thereof, or it may include grooves 48g on proximal face 48p only.

[078] Figure 17 illustrates yet another embodiment of a friction member 50 that includes a plurality of grooves 50g, eight in this illustrated embodiment. The friction member 50 is shown, in this illustrated embodiment, positioned within the first drum 44a, but the friction member 50 may be coupled with other types of drums. Slots 50g in this illustrated embodiment are each rectangular in shape and each extends along a partial width of the proximal face of friction member 50p. Slots extending along a partial width of a face of the friction member, rather than along the full width of the face, can facilitate fabrication of the friction member, for example, by facilitating stamping the slots into the face. As mentioned above, the friction member 50 may also include grooves on a distal face thereof, or it may only include grooves 50g on the proximal face 50p.

[079] Again, with reference to the embodiment of Figure 1, the first and second connection rods 22a and 22b can be configured to facilitate the actuation of the second end actuator 14 and, consequently, facilitate the articulation of the end actuator 8, regardless of the rotational position of the driveshaft assembly 6 about the longitudinal axis A of the driveshaft assembly. In other words, the third actuator 16 can be configured to be in any rotational position about the longitudinal axis A when the second actuator 14 is actuated to pivot the end actuator 8. The rotation of the drive shaft assembly 6 can rotate the first and second actuation shafts 26a, 26b of the actuation shaft assembly 6, as discussed herein, which adjust the position of the first and second actuation shafts 26a, 26b relative to the second actuator 14 and the actuation mechanism. The first and second connecting rods 22a and 22b can be configured to rotate within and relative to their respective pulleys 44a and 44b and respective friction members 40a, 40b during rotation of the drive shaft assembly 6 and the shift actuator. end 8, in response to actuation of the third actuator 16. Consequently, regardless of the rotational position of the first and second connecting rods 22a and 22b relative to their respective drums 44a and 44b and their respective friction members 40a and 40b, the first and second actuation shafts 26a, 26b coupled to the first and second connecting rods 22a, 22b can be moved proximally/distally in response to proximal/distal movement of the drums 44a and 44b and their respective friction members 40a and 40b during actuation of the second actuator 14. Similar to the first and second connection rods 22a and 22b, the closing mechanism 36 can be configured to facilitate the actuation of the first actuator 13 and, consequently, facilitate the movement of the cutting element, regardless of the rotational position of the assembly drive shaft assembly 6 about the longitudinal axis A of the drive shaft assembly.

[080] Figure 18 illustrates another embodiment of a surgical device 100. The device 100 can generally be configured and used similarly to the surgical device 2 of the embodiment of Figure 1 and similar to other embodiments of surgical devices described herein. Device 100 may include a proximal handle portion 102 including a main housing 118, a drive shaft assembly 104 extending distally from the handle portion 102, an end actuator (not shown) including a pair of jaws (or, in other embodiments, another type of actuation member) and being coupled to a distal end of the drive shaft assembly 104 at a pivot joint (not shown), electrodes (not shown), a first actuator 106 configured to to actuate the opening and closing of the opposing jaws and to effect movement of a cutting element (not shown) along the end actuator, a second actuator 108 configured to act on the end actuator linkage, a third actuator (not shown) configured to rotate the drive shaft assembly 104 and end actuator about a longitudinal axis of the drive shaft assembly 104, a fourth actuator 112 configured to turn the application of power on and off, a connected drive mechanism operational mode to the second actuator 108, a stationary cable 116 and a bending region (not shown).

[081] The device 100, in this illustrated embodiment, includes a conductive conductor 114 that is in the form of an RF cable in this illustrated embodiment, and can therefore be energized. In other embodiments, the surgical device may not be energized, for example, not configured to apply energy to tissue.

[082] The second actuator 108 of the device 100 can be configured to act on the end actuator joint in a similar way to the second actuator 14 of the device 2 discussed above. As shown in Figures 18 to 20, the second actuator 108 can be operatively coupled to a first barrel 110, a first connecting rod 120a, a first actuation shaft 122a, a second barrel (omitted in the figures for clarity of illustration ), a second connecting rod 120b and a second actuation shaft 122b. Rotation of the second actuator 108 can cause the end actuator to pivot in response to movement of the drums 110, the first and second connecting rods 120a and 120b, and the first and second actuation shafts 122a, 122b coupled thereto, similar to that discussed above with respect to the second actuator 14 of the device 2 discussed above.

[083] The device 100 may include a first friction member 124 associated with the first drum 110, the first connecting rod 120a and the first actuation axis 122a. Device 100 may also include a second friction member (omitted in the figures for clarity of illustration) associated with the second barrel, second connecting rod 120b, and second actuation shaft 122b. The first and second friction members 124 can be configured to provide increased resistance to rotation of the drive shaft assembly 104 and the end actuator attached thereto when the end actuator 8 is pivoted compared to when the end actuator is not. is hinged, similar to the first and second friction members 40a, 40b discussed above. In this illustrated embodiment, the first and second friction members 124 each include an engagement mechanism configured to apply an increased frictional force to an inner elongated drive shaft 126 of the drive shaft assembly 104 when the end actuator is engaged. articulated compared to when the end actuator is not articulated. Thus, similar to the first and second friction members 40a, 40b discussed above, the first and second friction members 124 can be configured to increase rotational torque when the end actuator is pivoted, for example, in the pivoted position. , compared to when the end actuator is not pivoted, for example, it is in the non-pivot position. In other words, the first and second friction members 124 can be configured to increase an amount of force required to rotate the drive shaft assembly 104 and the end actuator attached thereto when the end actuator is pivoted compared to when the end actuator is not pivoted.

[084] The first and second friction members 124 can have a variety of configurations. In general, each of the first and second friction members 124 can be configured to deform to shape. Each of the first and second friction members 124 may be elastomeric, e.g., made from one or more elastomeric materials (e.g., isoprene, silicone, etc.), to facilitate deformation out of shape. Each of the first and second friction members 124 can be configured to deform to shape in response to pressure applied thereto by the second actuator 108, as discussed further below. In general, the degree of deformation of each of the first and second friction members 124 can correspond to the pivot angle of the end actuator and an amount of rotational torque required to turn the drive shaft assembly 104 and the actuator. end. The greater the end actuator pivot angle (i.e., the closer the maximum pivot angle of the end actuator is to the longitudinal axis of the drive shaft assembly 104), the greater the degree of deformation and the more torque. rotational force needs to be applied to the third actuator (eg, an amount of hand force applied to it by a user) to rotate the driveshaft assembly 104 and the end actuator.

[085] As shown in Figures 18 to 21, the first friction member 124 may be ring-shaped and may have an internal passage 124i extending therethrough. The inner passage 124i may have a first diameter when the first friction member 124 is in a standard first undeformed uncompressed state. The first friction member 124 is shown in the first state in Figures 18 through 21. The diameter of the inner passage 124i can be configured to become smaller in response to pressure applied to the first friction ring 124 so that the first friction member 124 is in a second compressed deformed state. The first friction member 124 is shown in the second state in Figure 22.

[086] The device 100 may include a first non-rotating element 128 configured to maintain the first friction member 124 in a fixed rotational position with respect to the longitudinal axis of the drive shaft assembly 104. The first non-rotating element 128 may, thus be configured not to rotate in response to rotation of the second actuator 104 and thus not allow the first friction member 124 to rotate when the second actuator 104 rotates to pivot the end actuator. As shown in Figures 18 to 22, the first non-rotating element 128 can be configured to be disposed within the second actuator 108. The first non-rotating element 128 can be configured to be in a fixed rotational position within the second actuator 108 and to be in a fixed axial position along the longitudinal axis of the drive shaft assembly within the second actuator 108. The device 100 may include one or more guide pins 130a, 130b configured to mate with the first non-rotating member 128 to maintain the first cam element 128 in a fixed rotational position. The second actuator 108 may include a circumferential rib 132, on an inner surface thereof, which may be configured to seat in a corresponding circumferential groove 134 formed on an outer surface of the first non-rotating element 128. The rib 132, being circumferential, can help hold the first non-rotating member 128 in a fixed axial position, regardless of the rotational position of the second actuator 108 around the longitudinal axis of the drive shaft assembly 104.

[087] The first non-rotating element 128 can be rigidly attached to the first friction member 124 and thus be configured to maintain the first friction member 124 in a fixed rotational position within the second actuator 108. The first non-rotating element 128 and first friction member 124 may be fixedly attached together in a variety of ways, as will be understood by one skilled in the art, such as by adhesive, overlap molding of first friction member 124 to first non-rotatable member 128, friction fit, and the like.

[088] The second actuator 108 can include a first cam 130 on the inner surface thereof, configured to selectively engage the first friction member 124. The engagement of the first cam 130 with the first friction member 124 can be configured to cause the first friction member 124 deforms in shape. In other words, the first cam 130 can be configured to apply pressure to the first friction member 124 to cause the first friction member 124 to deform in shape, i.e., move from the first state to the second state, or move from one degree of deformation in the second state to another, greater degree of deformation in the second state. Similarly, the release of pressure applied to the first friction member 124 by the first cam 130 can cause the first friction member 124 to deform in shape, i.e., move from the second state to the first state or move from one state to another. one degree of second state strain to another lesser degree of second state strain. The first cam 130 may have an angled engagement surface 130s configured to engage the first friction member 124, which may allow the pressure applied to the first friction member 124 by the first cam 130 to increase in proportion to the increased pivot of the end actuator.

[089] The second friction member can be configured similarly to the first friction member 124, that is, it can have a ring shape, can have an internal passage extending therethrough, can be configured to move between the first and second states, may be coupled to a second non-rotating member (not shown) which may be configured similarly to the first non-rotating member 128 and may be configured to selectively engage a second cam (not shown) formed on the inner surface of the second actuator 108.

[090] In at least some embodiments, instead of including both first and second friction members 124, the surgical device may instead include only the first friction member 124 or only the second friction member. Including only one of the friction members can reduce the cost of the device and/or can facilitate device assembly.

[091] Figures 21 and 22 illustrate an embodiment of the actuation of the second actuator 108, thereby causing movement of the first friction member 124 and causing movement of the first and second actuation axes and, therefore, causing angular movement of the end actuator 8. Figure 21 illustrates a first position of the second actuator 108 and the first friction member 124 in its first state, which corresponds to the end actuator being in its non-pivoting position, for example, at an angle substantially equal to zero with respect to the longitudinal axis of the drive shaft assembly 104. With the first friction member 124 in its first state, the internal passage 124i thereof may have a minimum first diameter such that a gap 136 exists between the shaft elongated inner drive member 126 and the first friction member 124. The first cam 130 is disengaged from the first friction member 124, i.e. the engagement surface 130s thereof does not come into contact with the first friction member 124, so not to apply pressure to it with the end actuator in its non-pivoting position, for example, with the second actuator 108 in its first position.

[092] Figure 22 illustrates a second position of the second actuator 108 in which the second actuator 108 is rotated from the first position of Figure 21, for example, rotated counterclockwise, as shown by arrow R1. Rotation of the second actuator 108 causes the first barrel 110 to move distally and the second barrel to move proximally. The first barrel 110 moves within the second actuator 108 due to its threaded engagement with the first thread of the second actuator, and the second barrel moves within the second actuator 108 due to its threaded engagement with the second thread of the second actuator. Distal movement of the first drum 110 causes the first actuation shaft operatively connected thereto to move distally correspondingly. Similarly, distal movement of the second drum causes the second actuation shaft operatively connected thereto to move distally correspondingly. The end actuator has accordingly been pivoted to the left from its position in Figure 21. The first non-rotating member 128 is not moved in response to actuation of the second actuator 108 between Figures 21 and 22.

[093] The rotary movement of the second actuator 108 from Figure 21 to Figure 22 makes the first cam 130, that is, the engagement surface 130s thereof, engage the first friction member 124 and apply pressure to it. The first friction member 124 has consequently been deformed in shape as shown in Figure 22. The first friction member 124 has been moved into the gap 136 so as to be pressed against the outer surface of the inner elongated drive shaft 126, and the minimum diameter of the first friction member 124 has decreased to a second minimum diameter that is less than the first minimum diameter. The rotational torque required to rotate the inner elongated drive shaft 126, and hence the drive shaft 104 and end actuator assembly, is therefore greater than in Figure 21 due to the frictional force applied by the first friction member. 124 to the inner elongated drive shaft 126. As mentioned above, due to the angled engagement surface 130s of the first cam 130, the further the second actuator 108 is rotated from its non-pivoting position, i.e., the further the end actuator is angled from its non-pivoting position, more pressure is exerted by the first cam 130 on the first friction member 124 and therefore more force is required to be applied to the third actuator to rotate the drive shaft assembly 104 and the actuator end.

[094] The second friction member is not shown in Figures 21 and 22, but can move similarly to the first friction member 124 in response to actuation of the second actuator 108.

[095] Figures 23 and 24 illustrate another embodiment of a surgical device 200 that includes a friction member 202 in the form of a latch mechanism. Device 200 may generally be configured and used similarly to surgical device 100 of the embodiment of Figure 18 and similar to other embodiments of surgical devices described herein. In this illustrated embodiment, the friction member 202 is disposed within the second actuator of the device, i.e., the actuator configured to cause the end actuator to pivot with the handle portion 204 of the device. Rather, the friction member 202 is disposed elsewhere within the handle portion 204 of the device.

[096] The device 200 may include a driveshaft connector 206 at least partially disposed within the cable portion 204 that may be configured to facilitate the connection of a driveshaft assembly 208 of the device 200 to the cable portion 204. In response to pivoting an end actuator (not shown) at a distal end of the driveshaft assembly 208 from a non-pivoting position to a pivoting position, the driveshaft connector 206 can be configured to move in one direction. proximal. Similarly, in response to pivoting the end actuator from the pivoted position to the non-pivoting position, the driveshaft connector 206 can be configured to move in a distal direction.

[097] The friction member 202 can be, as in this illustrated embodiment, positioned within the cable portion 204 adjacent to the drive shaft assembly 208. By way of comparison, a drive shaft connector 138 of the device 100 located and configured similarly in Figure 18.

[098] In response to the end actuator being further pivoted (e.g., moved from the non-pivoting position to the pivoted position or moved from a pivoted position to a more pivoted position), the proximal movement of the drive shaft assembly 208 can apply pressure to the friction member 202 and consequently deform the shape of the friction member 202 and cause the friction member 202 to exert a force on the drive shaft assembly 208. to the device friction members 100, the friction member 202 can be configured to provide greater resistance to rotation of the drive shaft assembly 208 and the end actuator attached thereto when the end actuator is pivoted compared to when the end actuator is pivoted. End actuator is not pivoted. Similarly, in response to reduced articulation of the end actuator (e.g., moved from a pivoted position to a non-pivoting position or pivoted from a pivoted position to a less pivoted position), distal movement of the drive shaft assembly 208 may apply less pressure to friction member 202 and thereby deform the shape of friction member 202 and cause friction member 202 to exert less force on drive shaft assembly 208. In an exemplary embodiment, the member friction pad 202 can be configured to exert no force on the drive shaft assembly 208 when the end actuator is in the non-pivoting position, which can facilitate rotation of the drive shaft assembly 208 and the end actuator when the actuator end is not hinged.

[099] The friction member 202 has a half-ring shape in this illustrated embodiment, but the friction member 202 can have other shapes, for example, a full ring shape, a sphere, etc.

[0100] Figure 25 illustrates yet another embodiment of a surgical device 300 that includes a friction member 302 in the form of an engagement mechanism. Surgical device 300 may generally be configured and used similarly to surgical device 200 of the embodiment of Figures 23 and 24. In this illustrated embodiment, friction member 302 disposed adjacent to a driveshaft connector 204 is shaped ring-shaped, as opposed to the half-ring shape of friction member 202 of Figures 23 and 24.

[0101] Figure 26 illustrates the test results for the friction member 202 of Figures 23 and 24, for an example in which the friction member 202 is produced from a Morris Technology DM_9510_Grey80_Shore 65 material and is configured to be compressed 0.1 mm (0.005 inches). As shown in Figure 25, the force (in 7 newtons per millimeter (ounce force per inch)) required to rotate the 208 driveshaft assembly and end actuator clockwise or counterclockwise when the end is pivoted (labeled "straight" in Figure 25) is less than the force required to rotate the 208 driveshaft assembly and end actuator clockwise or counterclockwise when the end actuator is pivoted left or right.

[0102] The person skilled in the art will understand other features and advantages of the invention based on the embodiments described above. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended embodiments. All publications and references cited are expressly incorporated herein in full by reference.

Claims (7)

1. Surgical device, comprising: a handle (4); an elongated drive shaft (6) extending distally from the handle (4) and rotating with respect to the handle (4); and an end actuator (8) at a distal end of the elongated drive shaft (6) and having first and second claws (12a, 12b) that engage tissue therebetween, the end actuator (8) being pivotable with respect to the shaft elongated drive shaft (6) such that the end actuator (8) is angularly oriented with respect to the elongated drive shaft (6); a friction member (50) disposed within the handle (4) and resisting rotation of the elongated drive shaft (6) when the end actuator (8) is pivoted relative to the elongated drive shaft (6); and an actuator that is actuated to cause the elongated drive shaft (6) and the end actuator (8) with respect to the handle (4); wherein, when the end actuator (8) is pivoted with respect to the elongated drive shaft (6), a force required to rotate the elongated drive shaft (6) with respect to the cable (4) is greater than a force required for rotating the elongated drive shaft (6) relative to the cable (4) when the end actuator (8) is in a non-pivoting linear orientation with respect to the elongated drive shaft (6); wherein the friction member (50) has one or more slots formed therein that are locked with the actuator when the end actuator (8) is pivoted relative to the elongated drive shaft (6) and to be unlocked from the actuator when the end actuator (8) is in non-pivoting linear orientation; characterized in that each of the one or more grooves (40b) is rectangular in shape and extends along only a partial width of one face of the friction member (50). 2. Device according to claim 1, characterized in that the friction member (50) does not resist rotation of the elongated drive shaft (6) when the end actuator (8) is in non-articulated linear orientation. 3. Device according to claim 1, characterized in that the friction member (50) includes a mobile engagement mechanism between a locked configuration and an unlocked configuration based on the angle of the end actuator (8) in relation to to a longitudinal axis of the elongated drive shaft (6), the amount of force corresponding to whether the engagement mechanism is in the locked configuration or in the unlocked configuration, the device further comprising an actuator actuatable so as to cause rotational movement of the actuator and thereby causing articulation of the end actuator (8); wherein the friction member (50) is operatively coupled to the actuator such that rotational movement of the actuator causes rotational movement of the engagement mechanism. 4. Device according to claim 1, characterized in that the end actuator (8) rotates with the elongated drive shaft (6) in relation to the cable (4). 5. Device according to claim 1, characterized in that the elongated drive shaft (6) has a longitudinal axis, and the actuator is a first actuator (16) actuable in order to cause rotation of the elongated drive shaft (6) and the end actuator (8) around the longitudinal axis of the elongated drive shaft (6); the device further comprises a second actuator (14) actuatable so as to angularly adjust the end actuator (8) with respect to the longitudinal axis of the elongated drive shaft (6); and a friction member (50) that adjusts an amount of force required to be applied to the first actuator (16) to cause rotation of the elongated drive shaft (6) and end actuator (8) based on a angle of the end actuator (8) in relation to the longitudinal axis of the elongated drive shaft (6). 6. Device according to claim 5, characterized in that the greater the angle of the end actuator (8) in relation to the longitudinal axis of the elongated drive shaft (6), the greater the amount of force that the member frictional friction (50) requires that it be applied to the first actuator (16) to cause rotation of the elongated drive shaft (6) and end actuator (8). 7. Device according to claim 5, characterized in that the friction member (50) includes a mobile engagement mechanism between a locked configuration and an unlocked configuration based on the angle of the end actuator (8) with respect to the longitudinal axis of the elongated drive shaft (6), the amount of force corresponding to whether the engagement mechanism is in the locked configuration or in the unlocked configuration.