CA3006045A1 - Surgical instrumentfor penetration of tissue layers - Google Patents
Surgical instrumentfor penetration of tissue layers Download PDFInfo
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- CA3006045A1 CA3006045A1 CA3006045A CA3006045A CA3006045A1 CA 3006045 A1 CA3006045 A1 CA 3006045A1 CA 3006045 A CA3006045 A CA 3006045A CA 3006045 A CA3006045 A CA 3006045A CA 3006045 A1 CA3006045 A1 CA 3006045A1
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- Prior art keywords
- edge
- surgical instrument
- cutting
- cutting feature
- feature
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/295—Forceps for use in minimally invasive surgery combined with cutting implements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3209—Incision instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3454—Details of tips
Abstract
An instrument for surgical insertion and penetration of tissue layers includes a shaft, a distally facing end surface, and at least one cutting feature positioned on the distally-facing end surface. The at least one cutting feature is structurally configured to be atraumatic when not rotated. The at least one cutting feature enables cutting of tissue when the at least one cutting feature is rotated about a rotational axis. The at least one cutting feature can comprise a cutting edge that is positioned tangential relative to an imaginary cylinder centered on the rotational axis and/or a cutting edge that is positioned such that a plane defined along the cutting edge does not extend through the rotational axis.
Description
SURGICAL INSTRUMENTFOR PENETRATION OF TISSUE LAYERS
CROSS-REFERENCE TO RELATED APPLICATIONS
This Application claims the benefit of U.S. Provisional Patent Application No.
62/260,112, entitled "SURGICAL INSTRUMENT FOR PENETRATION OF
TISSUE LAYERS," which was filed on November 25, 2015 and which is hereby incorporated by reference in its entirety.
FIELD OF THE INVENTION
The present invention generally relates to a surgical instrument, apparatus or device for surgical insertion and/or penetration through patient tissue, such as an abdominal wall.
BACKGROUND OF THE INVENTION
Subcutaneous surgical spaces generally have been accessed during surgery using devices that either cut or bluntly penetrate the patient's tissue, with each type of device providing respective benefits and drawbacks. The current state of abdominal surgery consists of two general surgical methods - open surgery and minimally invasive surgery (MIS). With open surgery, the surgeon creates a cut in the abdomen that can be many inches long in order to create an opening in the abdomen through which the operation is performed. Drawbacks of this method are that a large scar is left on the patient's abdomen and there is a lengthy healing period. MIS techniques, on the other hand, limit the scarring and shorten the recovery period. While there are a number of different types of MIS based upon the type of surgery and the location on the body, certain features, aspects and advantages of the present invention relate to abdominal MIS surgery, also known as laparoscopy.
In laparoscopy, the abdomen is inflated, thereby moving the abdomen away from other internal organs to create a surgical space. The abdomen is inflated to create the expanded abdominal state called pneumoperitonetm). The next step is to introduce surgical instruments to perform an operation within the abdominal cavity, The current method of introducing surgical instruments is to use a trocar to allow surgical instruments to pass in and out of the abdominal cavity. The trocar is a combination of a cannula and an obturator. The obturator is the piercing portion of the device that introduces the cannula portion through the abdominal wall.
The obturator then is removed after introduction, leaving the cannula in place.
The cannula has a seal that reduces the likelihood of the insufflation gas escaping while allowing medical instruments to pass through it.
While the use of the trocar is a standard practice for MIS surgery, it has some shortcomings. First, the obturator used to introduce the cannula has a very sharp point that, if driven too far into the cavity can nick organs or arteries, which in turn can cause complications. Second, a scar is created at the site of the trocar because of the relatively larger diameter of the trocar compared to the instruments that pass through the trocar.
Certain features, aspects and advantages of the proposed surgical instruments reduce or eliminate the need for a trocar without incurring any significant costs to implement the proposed surgical instruments. On the other hand, overall procedure cost is reduced through the use of the proposed surgical instruments.
SUMMARY OF THE INVENTION
Certain features, aspects and advantages of the present invention allow standard surgical instruments to enter the abdominal cavity without using a trocar. Although the proposed surgical instruments facilitate access to the abdominal cavity, the proposed surgical instruments are intended to be atraumatic to the internal organs once a distal portion of the proposed surgical instruments enter the abdominal cavity.
While the prior art demonstrates percutaneously introducible instruments having extendable blades that are retracted after introduction of the instruments into the surgical space, these designs add complexity and cost and have not been widely adopted by the surgical community. These instruments also present safety concerns with the prospect of having a sharp blade enter the abdominal cavity.
CROSS-REFERENCE TO RELATED APPLICATIONS
This Application claims the benefit of U.S. Provisional Patent Application No.
62/260,112, entitled "SURGICAL INSTRUMENT FOR PENETRATION OF
TISSUE LAYERS," which was filed on November 25, 2015 and which is hereby incorporated by reference in its entirety.
FIELD OF THE INVENTION
The present invention generally relates to a surgical instrument, apparatus or device for surgical insertion and/or penetration through patient tissue, such as an abdominal wall.
BACKGROUND OF THE INVENTION
Subcutaneous surgical spaces generally have been accessed during surgery using devices that either cut or bluntly penetrate the patient's tissue, with each type of device providing respective benefits and drawbacks. The current state of abdominal surgery consists of two general surgical methods - open surgery and minimally invasive surgery (MIS). With open surgery, the surgeon creates a cut in the abdomen that can be many inches long in order to create an opening in the abdomen through which the operation is performed. Drawbacks of this method are that a large scar is left on the patient's abdomen and there is a lengthy healing period. MIS techniques, on the other hand, limit the scarring and shorten the recovery period. While there are a number of different types of MIS based upon the type of surgery and the location on the body, certain features, aspects and advantages of the present invention relate to abdominal MIS surgery, also known as laparoscopy.
In laparoscopy, the abdomen is inflated, thereby moving the abdomen away from other internal organs to create a surgical space. The abdomen is inflated to create the expanded abdominal state called pneumoperitonetm). The next step is to introduce surgical instruments to perform an operation within the abdominal cavity, The current method of introducing surgical instruments is to use a trocar to allow surgical instruments to pass in and out of the abdominal cavity. The trocar is a combination of a cannula and an obturator. The obturator is the piercing portion of the device that introduces the cannula portion through the abdominal wall.
The obturator then is removed after introduction, leaving the cannula in place.
The cannula has a seal that reduces the likelihood of the insufflation gas escaping while allowing medical instruments to pass through it.
While the use of the trocar is a standard practice for MIS surgery, it has some shortcomings. First, the obturator used to introduce the cannula has a very sharp point that, if driven too far into the cavity can nick organs or arteries, which in turn can cause complications. Second, a scar is created at the site of the trocar because of the relatively larger diameter of the trocar compared to the instruments that pass through the trocar.
Certain features, aspects and advantages of the proposed surgical instruments reduce or eliminate the need for a trocar without incurring any significant costs to implement the proposed surgical instruments. On the other hand, overall procedure cost is reduced through the use of the proposed surgical instruments.
SUMMARY OF THE INVENTION
Certain features, aspects and advantages of the present invention allow standard surgical instruments to enter the abdominal cavity without using a trocar. Although the proposed surgical instruments facilitate access to the abdominal cavity, the proposed surgical instruments are intended to be atraumatic to the internal organs once a distal portion of the proposed surgical instruments enter the abdominal cavity.
While the prior art demonstrates percutaneously introducible instruments having extendable blades that are retracted after introduction of the instruments into the surgical space, these designs add complexity and cost and have not been widely adopted by the surgical community. These instruments also present safety concerns with the prospect of having a sharp blade enter the abdominal cavity.
- 2 -Certain existing devices have an extending blade for percutaneous penetration that retracts once the device is in the body.
Certain features, aspects and advantages of the present invention pertain to one or more cutting features configured to be positioned on distal ends of surgical instruments. In some cases, the instruments can comprise graspers or forceps.
The feature or features on the distal end of the instrument allow the instrument to cut through the abdominal wall when the instrument is moved with a rotational or torsional motion about a longitudinal axis extending from the distal end of the instrument, either with a unidirectional rotation or torsion (e.g., robotic rotation or torsion) or bi-directional reciprocating rotation (e.g., hand-held rotation or torsion) while the instrument is concurrently urged axially along the same longitudinal axis against the abdominal wall tissues intended to be cut. With the illustrated surgical instruments, the cutting features are not retractable or otherwise movable relative to the distal end of the instrument. The contemplated instruments have cutting features positioned on external distal-facing surfaces. In addition, the cutting features remain in the same position relative to the instruments and are not retractable or otherwise movable in relation to the distal end of the instruments throughout the surgery. Thus, the simplicity and added safety offered by this design are an improvement over existing devices.
The at least one cutting feature that allows the instrument to cut through the tissues ofthe abdominal wall can include an edge created by adjacent surfaces that converge at an included angle that is greater than the included angle of a standard blade. The standard blade is believed to consist of two walls that converge at an included angle of 20 degrees or less. The convergence of the adjacent surfaces at an angle of more than 20 degrees causes the juncture of these adjacent surfaces to be sufficiently blunt to be atraumatic during axial movements or rotational movements without axial force such as may be encountered during normal surgical maneuvers. The larger the included angle, the more blunt the edge.
Axial force is used to urge the distal end of the instrument, which incorporates the at least one cutting feature, into the abdominal tissue. In some configurations, the
Certain features, aspects and advantages of the present invention pertain to one or more cutting features configured to be positioned on distal ends of surgical instruments. In some cases, the instruments can comprise graspers or forceps.
The feature or features on the distal end of the instrument allow the instrument to cut through the abdominal wall when the instrument is moved with a rotational or torsional motion about a longitudinal axis extending from the distal end of the instrument, either with a unidirectional rotation or torsion (e.g., robotic rotation or torsion) or bi-directional reciprocating rotation (e.g., hand-held rotation or torsion) while the instrument is concurrently urged axially along the same longitudinal axis against the abdominal wall tissues intended to be cut. With the illustrated surgical instruments, the cutting features are not retractable or otherwise movable relative to the distal end of the instrument. The contemplated instruments have cutting features positioned on external distal-facing surfaces. In addition, the cutting features remain in the same position relative to the instruments and are not retractable or otherwise movable in relation to the distal end of the instruments throughout the surgery. Thus, the simplicity and added safety offered by this design are an improvement over existing devices.
The at least one cutting feature that allows the instrument to cut through the tissues ofthe abdominal wall can include an edge created by adjacent surfaces that converge at an included angle that is greater than the included angle of a standard blade. The standard blade is believed to consist of two walls that converge at an included angle of 20 degrees or less. The convergence of the adjacent surfaces at an angle of more than 20 degrees causes the juncture of these adjacent surfaces to be sufficiently blunt to be atraumatic during axial movements or rotational movements without axial force such as may be encountered during normal surgical maneuvers. The larger the included angle, the more blunt the edge.
Axial force is used to urge the distal end of the instrument, which incorporates the at least one cutting feature, into the abdominal tissue. In some configurations, the
- 3 -at least one cutting feature must be fully or sufficiently surrounded by the tissue intended to be cut, With the distal end of the instrument urged against the abdominal tissue, the instrument can be rotated about the axis of the instrument shaft while the abdominal tissue surrounds the cutting features. Once inside the body, the instrument can be used in the same way it is typically used (e.g., grasping in the case of graspers) without concern from the surgeon of inadvertent damage being caused by the cutting features, which are atraumatic during axial movement and during rotational movement without significant simultaneous axial forces.
An aspect of an embodiment of the present invention contemplates an instrument for surgical insertion. The instrument may include an instrument shaft and at least one jaw moveably connected to the shaft. An example of such an instrument can be found in U.S. Patent No. 8,968,358, issued on March 3, 2015, which is hereby incorporated by reference in its entirety. In that instrument, a pair of moveable jaws is disclosed. In accordance with certain features, aspects and advantages of the present invention, one or more of a pair of jaws of the instrument can include one or more cutting feature. Any tissue grasping features on the inside or opposed grasping surfaces of the one or more of the pair jaws may remain unaltered.
In some aspects of embodiments of the present invention, the surfaces that converge or approach each other to create the one or more cutting feature(s) are not overly acute in relation to each other. In some embodiments, the surfaces approach each other and define an included angle of between 45 and 120 degrees.
In some embodiments, the one or more cutting feature(s) do not intersect the rotational axis of the instrument. In some embodiments, a tissue relief area is positioned adjacent to the one or more cutting feature(s). The cutting feature(s) may be bounded on the top and bottom by a planar or gently arched surface. The combination of the bounding surface and the larger included angle allows impacted tissue to conform to the one or more cutting feature(s) and, when the instrument is rotated (or at least the distal end of the instrument is rotated), the one or more cutting feature(s) may be swept across the impacted tissue, thus effecting the cutting action.
An aspect of an embodiment of the present invention contemplates an instrument for surgical insertion. The instrument may include an instrument shaft and at least one jaw moveably connected to the shaft. An example of such an instrument can be found in U.S. Patent No. 8,968,358, issued on March 3, 2015, which is hereby incorporated by reference in its entirety. In that instrument, a pair of moveable jaws is disclosed. In accordance with certain features, aspects and advantages of the present invention, one or more of a pair of jaws of the instrument can include one or more cutting feature. Any tissue grasping features on the inside or opposed grasping surfaces of the one or more of the pair jaws may remain unaltered.
In some aspects of embodiments of the present invention, the surfaces that converge or approach each other to create the one or more cutting feature(s) are not overly acute in relation to each other. In some embodiments, the surfaces approach each other and define an included angle of between 45 and 120 degrees.
In some embodiments, the one or more cutting feature(s) do not intersect the rotational axis of the instrument. In some embodiments, a tissue relief area is positioned adjacent to the one or more cutting feature(s). The cutting feature(s) may be bounded on the top and bottom by a planar or gently arched surface. The combination of the bounding surface and the larger included angle allows impacted tissue to conform to the one or more cutting feature(s) and, when the instrument is rotated (or at least the distal end of the instrument is rotated), the one or more cutting feature(s) may be swept across the impacted tissue, thus effecting the cutting action.
- 4 -
5 A certain amount of axial pushing force is required to make the tissue move into the tissue relief and wrap around or otherwise engage the one or more cutting feature(s). The surgical instrument is atraumatic during normal surgical maneuvers because the requisite level of axial force is only used when initially introducing instruments through the abdominal tissues. The additional necessity of a rotational motion in order to cut tissue yields a surgical instrument that requires two distinct motions or actions to generate the desired cutting performance.
The one or more cutting feature(s) may be a flat edge that lies within a plane that is perpendicular to the axis of rotation of the distal end of the surgical instrument.
The one or more cutting feature(s) may also have the ends of the one or more cutting feature(s) that are disposed within a plane that is perpendicular to the axis of rotation while the center portion of the edge bows in a distal direction out of that plane. In addition to either of these configurations, the surfaces defining the one or more cutting feature(s) may be tangential to a circle that is concentric to, or coaxial with, the axis of rotation of the distal end of the surgical instrument, or the edge itself is concentric to, or axially aligned with, the axis of rotation of the distal end of the surgical instrument. In some embodiments, the surgical instrument has a single axis of rotation that extends through the axis of rotation of the distal end of the surgical instrument. This, in some non-limiting aspects of embodiments of the present invention, gives four general edge shapes: tangential-flat, tangential-bowed, concentric-flat, and concentric-bowed.
The atraumatic cutting feature(s) described herein can be put on any instrument that can accommodate the feature combinations that create the atraumatic cutting feature(s). In one aspect of an embodiment of the present invention, the contemplated surgical instrument, which may be used and designed for laparoscopic surgery, may include a distal end of a generally cylindrical shape having a combination of opposing chamfered surfaces with one or more tissue relief areas within the bounds of the chamfered surfaces. The surgical instrument may be divided between two parts that together form the end shape, such as with a grasper that has two opposable members that in the closed position create a cylindrical shape. In some configurations, the at least one cutting feature can be positioned on an otherwise standard obturator.
In some configurations, the at least one cutting feature of the surgical instrument may be on either or both jaws. In at least some of the illustrated embodiments, the features on both jaws may combine to create the full cutting feature(s). In some configurations, the at least one cutting feature on one jaw does not align with any cutting feature on the opposing jaw. In some embodiments, the at least one cutting feature of the first jaw may be misaligned with all cutting features of the second jaw. In some configurations, the at least one cutting feature of the first jaw may be aligned with a corresponding at least one cutting feature of the second jaw.
In some embodiments, the at least one cutting feature may be positioned away from the center or axis of rotation of the distal end of the surgical instrument or the complete surgical instrument. Tissue relief features of the distal-facing end surface of the surgical instrument may be positioned away from, or cross, the axis of rotation of the tissue-penetrating portion of the surgical instrument. The at least one cutting feature may be positioned so as to not intersect the rotational axis (and/or not have a longitudinally-extending surface defined through the at least one edge of the at least one cutting feature extend through the rotational axis), with the at least one cutting feature being bound on either end by a generally planar surface. In some embodiments, the generally planar surface may be generally perpendicular with respect to the edge of the at least one cutting feature.
In some embodiments, the planar surface extend at an angle of between 5 and 20 degrees with respect to grasping plane with the distal portion of the planar surface being closer to the axis of rotation than the proximal end of the planar surface.
In accordance with certain features, aspects and advantage of an embodiment of the present invention, a surgical instrument comprises a shaft having a proximal end and a distal end. A distally-facing surface is disposed at the distal end of the surgical instrument. A rotational axis extends through the distally-facing surface at the distal end of the surgical instrument. At least one cutting feature is
The one or more cutting feature(s) may be a flat edge that lies within a plane that is perpendicular to the axis of rotation of the distal end of the surgical instrument.
The one or more cutting feature(s) may also have the ends of the one or more cutting feature(s) that are disposed within a plane that is perpendicular to the axis of rotation while the center portion of the edge bows in a distal direction out of that plane. In addition to either of these configurations, the surfaces defining the one or more cutting feature(s) may be tangential to a circle that is concentric to, or coaxial with, the axis of rotation of the distal end of the surgical instrument, or the edge itself is concentric to, or axially aligned with, the axis of rotation of the distal end of the surgical instrument. In some embodiments, the surgical instrument has a single axis of rotation that extends through the axis of rotation of the distal end of the surgical instrument. This, in some non-limiting aspects of embodiments of the present invention, gives four general edge shapes: tangential-flat, tangential-bowed, concentric-flat, and concentric-bowed.
The atraumatic cutting feature(s) described herein can be put on any instrument that can accommodate the feature combinations that create the atraumatic cutting feature(s). In one aspect of an embodiment of the present invention, the contemplated surgical instrument, which may be used and designed for laparoscopic surgery, may include a distal end of a generally cylindrical shape having a combination of opposing chamfered surfaces with one or more tissue relief areas within the bounds of the chamfered surfaces. The surgical instrument may be divided between two parts that together form the end shape, such as with a grasper that has two opposable members that in the closed position create a cylindrical shape. In some configurations, the at least one cutting feature can be positioned on an otherwise standard obturator.
In some configurations, the at least one cutting feature of the surgical instrument may be on either or both jaws. In at least some of the illustrated embodiments, the features on both jaws may combine to create the full cutting feature(s). In some configurations, the at least one cutting feature on one jaw does not align with any cutting feature on the opposing jaw. In some embodiments, the at least one cutting feature of the first jaw may be misaligned with all cutting features of the second jaw. In some configurations, the at least one cutting feature of the first jaw may be aligned with a corresponding at least one cutting feature of the second jaw.
In some embodiments, the at least one cutting feature may be positioned away from the center or axis of rotation of the distal end of the surgical instrument or the complete surgical instrument. Tissue relief features of the distal-facing end surface of the surgical instrument may be positioned away from, or cross, the axis of rotation of the tissue-penetrating portion of the surgical instrument. The at least one cutting feature may be positioned so as to not intersect the rotational axis (and/or not have a longitudinally-extending surface defined through the at least one edge of the at least one cutting feature extend through the rotational axis), with the at least one cutting feature being bound on either end by a generally planar surface. In some embodiments, the generally planar surface may be generally perpendicular with respect to the edge of the at least one cutting feature.
In some embodiments, the planar surface extend at an angle of between 5 and 20 degrees with respect to grasping plane with the distal portion of the planar surface being closer to the axis of rotation than the proximal end of the planar surface.
In accordance with certain features, aspects and advantage of an embodiment of the present invention, a surgical instrument comprises a shaft having a proximal end and a distal end. A distally-facing surface is disposed at the distal end of the surgical instrument. A rotational axis extends through the distally-facing surface at the distal end of the surgical instrument. At least one cutting feature is
- 6 -positioned on the distally-facing surface at the distal end of the surgical instrument. The at least one cutting feature is formed by an edge created by at least two adjacent surfaces. At least one tissue relief feature is positioned adjacent to the cutting feature and is partially defined by at least one of the at least two adjacent surfaces that create the edge of the at least one cutting feature.
The at least one cutting feature is arranged to cut tissue when the shaft is rotated about the rotational axis while the distally-facing surface at the distal end of the surgical instrument is urged into the tissue.
In some configurations, the surgical instrument comprises a first jaw and a second jaw with at least one of the first jaw and the second jaw being moveably connected to the shaft. The distally-facing surface at the distal end of the surgical instrument comprises a distal end of at least one of the first jaw and the second jaw.
In some configurations, an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle is within a range of 45 to 120 degrees.
In some configurations, an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle being greater than 45 degrees.
In some configurations, the included angle is greater than 55 degrees.
In some configurations, an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle is large enough that the resulting edge can cut through the abdominal wall only when subjected to at least 1 pound of axial force while being rotated.
In some configurations, a shape of the edge of the at least one cutting feature is a linear edge that extends tangential to a circle that is centered on the rotational axis while the linear edge also is within a plane that is perpendicular to the rotational axis.
The at least one cutting feature is arranged to cut tissue when the shaft is rotated about the rotational axis while the distally-facing surface at the distal end of the surgical instrument is urged into the tissue.
In some configurations, the surgical instrument comprises a first jaw and a second jaw with at least one of the first jaw and the second jaw being moveably connected to the shaft. The distally-facing surface at the distal end of the surgical instrument comprises a distal end of at least one of the first jaw and the second jaw.
In some configurations, an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle is within a range of 45 to 120 degrees.
In some configurations, an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle being greater than 45 degrees.
In some configurations, the included angle is greater than 55 degrees.
In some configurations, an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle is large enough that the resulting edge can cut through the abdominal wall only when subjected to at least 1 pound of axial force while being rotated.
In some configurations, a shape of the edge of the at least one cutting feature is a linear edge that extends tangential to a circle that is centered on the rotational axis while the linear edge also is within a plane that is perpendicular to the rotational axis.
- 7 -In some configurations, the edge extends in a first direction and at least one jaw pivots about a pivot axis with the pivot axis extending perpendicular to the first direction.
In some configurations, the at least one cutting feature is defined by three distinct surfaces with the three distinct surfaces comprising an inner surface, an outer surface that converges with the inner surface, and a fillet surface that forms an outer boundary of the outer surface.
In some configurations, a shape of the edge of the at least one cutting feature is concentric to the rotational axis while also being positioned within a plane that is perpendicular to the rotational axis.
In some configurations, a shape of the edge of the at least one cutting feature is concentric to the rotational axis while the edge bows outwardly in a distal direction out of a plane that is perpendicular to the rotational axis.
In some configurations, a shape of the edge of the at least one cutting feature is a straight edge that extends tangential to a circle that is centered on the rotational axis while the edge bows outwardly in a distal direction out of a plane that is perpendicular to the rotational axis.
In some configurations, the edge of the at least one cutting feature does not cross the rotational axis.
In some configurations, the edge of the at least one cutting feature is bounded at each end by a planar surface that is angled such that a distal portion of the planar surface is closer to the rotational axis than a proximal portion of the planar surface.
In some configurations, the planar surface has an incline angle of between 5 and 20 degrees.
In some configurations, the angled surface is oriented perpendicular to the edge of the at least one cutting feature.
In some configurations, the at least one cutting feature is defined by three distinct surfaces with the three distinct surfaces comprising an inner surface, an outer surface that converges with the inner surface, and a fillet surface that forms an outer boundary of the outer surface.
In some configurations, a shape of the edge of the at least one cutting feature is concentric to the rotational axis while also being positioned within a plane that is perpendicular to the rotational axis.
In some configurations, a shape of the edge of the at least one cutting feature is concentric to the rotational axis while the edge bows outwardly in a distal direction out of a plane that is perpendicular to the rotational axis.
In some configurations, a shape of the edge of the at least one cutting feature is a straight edge that extends tangential to a circle that is centered on the rotational axis while the edge bows outwardly in a distal direction out of a plane that is perpendicular to the rotational axis.
In some configurations, the edge of the at least one cutting feature does not cross the rotational axis.
In some configurations, the edge of the at least one cutting feature is bounded at each end by a planar surface that is angled such that a distal portion of the planar surface is closer to the rotational axis than a proximal portion of the planar surface.
In some configurations, the planar surface has an incline angle of between 5 and 20 degrees.
In some configurations, the angled surface is oriented perpendicular to the edge of the at least one cutting feature.
- 8 -In some configurations, the at least one cutting feature is enhanced with a spur-like feature.
In some configurations, the at least one cutting feature is enhanced with a serration-like feature.
In some configurations, the at least one tissue relief feature comprises a rounded tissue relief edge that is positioned away from the edge of the at least one cutting edge.
BRIEF DESCRIPTION OF THE DRAWINGS
Further aspects of embodiments of the present invention may be featured, displayed, and/or represented in the accompanying drawings.
Further aspects of embodiments of the present invention may be featured, displayed, and/or represented in the accompanying drawings, which are intended to illustrate but to not limit the present invention.
FIG. 1 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a tangential-flat edge type of cutting feature.
FIG. 1B is another isometric view of the surgical instrument of FIG. 1.
FIG. 2 is a top view of the surgical instrument of FIG. 1.
FIG. 2A is an enlarged isometric view of the surgical instrument of FIG. 1.
FIG. 2B is an enlarged isometric view of another surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention.
FIG. 3 is an isometricview of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presentsa tangential-flat
In some configurations, the at least one cutting feature is enhanced with a serration-like feature.
In some configurations, the at least one tissue relief feature comprises a rounded tissue relief edge that is positioned away from the edge of the at least one cutting edge.
BRIEF DESCRIPTION OF THE DRAWINGS
Further aspects of embodiments of the present invention may be featured, displayed, and/or represented in the accompanying drawings.
Further aspects of embodiments of the present invention may be featured, displayed, and/or represented in the accompanying drawings, which are intended to illustrate but to not limit the present invention.
FIG. 1 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a tangential-flat edge type of cutting feature.
FIG. 1B is another isometric view of the surgical instrument of FIG. 1.
FIG. 2 is a top view of the surgical instrument of FIG. 1.
FIG. 2A is an enlarged isometric view of the surgical instrument of FIG. 1.
FIG. 2B is an enlarged isometric view of another surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention.
FIG. 3 is an isometricview of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presentsa tangential-flat
- 9 -edge type bounded by an angled surface that does not extend a full length of a jaw.
FIG. 4 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a concentric-flat edge type bounded by an angled surface that does not extend a full length of a jaw.
FIG. 5 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a tangential-bowed edge type.
FIG.5B is an isometric view of a surgical instrument that is similar in many respects to the surgical instrument of FIG.5 but that includes a spur-type edge enhancement.
FIG.5C is an isometric view of a surgical instrument that is similar in many respects to the surgical instrument of FIG.5 but that includes a serration-type edge enhancement.
FIG. 6 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a concentric-bowed edge type.
FIG. 7 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a tangential-bowed edge type bounded by an angled surface that does not extend a full length of a jaw.
FIG. 8 is a side view of the surgical instrument of FIG. 7, which further demonstrates the bowed edge.
FIG. 4 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a concentric-flat edge type bounded by an angled surface that does not extend a full length of a jaw.
FIG. 5 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a tangential-bowed edge type.
FIG.5B is an isometric view of a surgical instrument that is similar in many respects to the surgical instrument of FIG.5 but that includes a spur-type edge enhancement.
FIG.5C is an isometric view of a surgical instrument that is similar in many respects to the surgical instrument of FIG.5 but that includes a serration-type edge enhancement.
FIG. 6 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a concentric-bowed edge type.
FIG. 7 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a tangential-bowed edge type bounded by an angled surface that does not extend a full length of a jaw.
FIG. 8 is a side view of the surgical instrument of FIG. 7, which further demonstrates the bowed edge.
- 10 -FIG. 9 is an isometric view of a surgical instrument that is arranged and configured in accordance with certain features, aspects and advantage of an embodiment of the present invention. This embodiment demonstrates the tangential-bowed edge type with the cutting feature parallel to the grasping plane of the surgical instrument.
FIG. lOillustrates an isometric view of a surgical instrument arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a tangential-bowed edge type with a cutting feature that is angled between a perpendicular style, such as that of FIG. 5, and a parallel style, such as that of FIG. 9.
FIG. 11 is a side view of the surgical instrument of FIG. 10, which further demonstrates the bowed cutting edge.
FIG. 12is an isometric view of a Maryland-type grasper with jaws presenting a tangential-bowed edge that is bounded by an angled surface that does not extend a full length of a jaw.
FIG.12B is an enlarged view of the Maryland-type grasper of FIG.12, which view further illustrates the edge construction.
DETAILED DESCRIPTION OF THE INVENTION
FIG. 1 demonstrates a surgical instrument 10. The surgical instrument 10 has a shaft 22. The shaft 22 has a proximal end (not shown) and a distal end. The distal end is configured to be inserted into a body cavity during a surgical operation.
In some configurations, the distal end of the shaft 22 includes at least one jaw. In the illustrated configuration, a pair of jaws 12A,12B are moveably connected to the distal end of the shaft 22. In some configurations, one of the pair of jaws 12A, 12B is fixed relative to the shaft 22 while the other of the pair of jaws 12A, 12B is moveable relative to the shaft 22. The pair of jaws 12A, 12B are structured to
FIG. lOillustrates an isometric view of a surgical instrument arranged and configured in accordance with certain features, aspects and advantages of an embodiment of the present invention. The illustrated surgical instrument presents a tangential-bowed edge type with a cutting feature that is angled between a perpendicular style, such as that of FIG. 5, and a parallel style, such as that of FIG. 9.
FIG. 11 is a side view of the surgical instrument of FIG. 10, which further demonstrates the bowed cutting edge.
FIG. 12is an isometric view of a Maryland-type grasper with jaws presenting a tangential-bowed edge that is bounded by an angled surface that does not extend a full length of a jaw.
FIG.12B is an enlarged view of the Maryland-type grasper of FIG.12, which view further illustrates the edge construction.
DETAILED DESCRIPTION OF THE INVENTION
FIG. 1 demonstrates a surgical instrument 10. The surgical instrument 10 has a shaft 22. The shaft 22 has a proximal end (not shown) and a distal end. The distal end is configured to be inserted into a body cavity during a surgical operation.
In some configurations, the distal end of the shaft 22 includes at least one jaw. In the illustrated configuration, a pair of jaws 12A,12B are moveably connected to the distal end of the shaft 22. In some configurations, one of the pair of jaws 12A, 12B is fixed relative to the shaft 22 while the other of the pair of jaws 12A, 12B is moveable relative to the shaft 22. The pair of jaws 12A, 12B are structured to
- 11 -grasp and release body tissue, for example, by opening and closing about a grasping plane 8 (see FIG. 1B).
With reference again to FIG. 1, the jaws 12A, 12B of the surgical instrument preferably include one or more cutting edges 20. In the illustrated configuration, contiguous to the cutting edges 20 are formed tissue relief features 16. The cutting edges 20 and the tissue relief features 16 are positioned on the distal end of the surgical instrument 10. More particularly, in some configurations, the cutting edges 20 and the tissue relief features 16 are positioned on a distally-facing end surface of the surgical instrument 10. Such a placement allows the cutting edges 20 to engage with tissue through axial movement and/or force. While the presence of the tissue relief areas 16 may have a small effect on the grasping surfaces of the jaws 12A,12B, the tissue relief 16 is not believed to interfere or significantly impact grasping use or operation of the jaws 12A, 12B.
During surgical use of the surgical instrument 10, the tissue relief features16 allow tissue to conform around the cutting edge 20 when the distal end of the surgical instrument 10 is pushed axially in a distal direction against body tissue.
With the tissue conformed around the cutting edge 20, when the surgical instrument 10 is the rotated around a rotational axis 18, the edge 20 will penetrate, carve or scrape tissue that passes against the cutting edge 20, which facilitates penetration of the body tissue by the surgical instrument 10.
As shown in the configuration of Figure 1, in some configurations, the largest profile of the most distal end of the surgical instrument is smaller than or consistent with the diameter or profile of the portion of the shaft that is intended to pass through the tissue of the patient during a surgical operation. In other words, the entirety of the pair of jaws 12A, 12B of FIG. 1 have a smaller perimeter (e.g., a smaller vertical cross sectional area) than the most distal portion of the shaft to which the pair of jaws 12A, 12B are connected. As such, the portion of the surgical instrument that first penetrates the tissue does not require a larger bore through the tissue than the portion of the shaft or body of the surgical instrument that is expected to pass through the bore.
With reference again to FIG. 1, the jaws 12A, 12B of the surgical instrument preferably include one or more cutting edges 20. In the illustrated configuration, contiguous to the cutting edges 20 are formed tissue relief features 16. The cutting edges 20 and the tissue relief features 16 are positioned on the distal end of the surgical instrument 10. More particularly, in some configurations, the cutting edges 20 and the tissue relief features 16 are positioned on a distally-facing end surface of the surgical instrument 10. Such a placement allows the cutting edges 20 to engage with tissue through axial movement and/or force. While the presence of the tissue relief areas 16 may have a small effect on the grasping surfaces of the jaws 12A,12B, the tissue relief 16 is not believed to interfere or significantly impact grasping use or operation of the jaws 12A, 12B.
During surgical use of the surgical instrument 10, the tissue relief features16 allow tissue to conform around the cutting edge 20 when the distal end of the surgical instrument 10 is pushed axially in a distal direction against body tissue.
With the tissue conformed around the cutting edge 20, when the surgical instrument 10 is the rotated around a rotational axis 18, the edge 20 will penetrate, carve or scrape tissue that passes against the cutting edge 20, which facilitates penetration of the body tissue by the surgical instrument 10.
As shown in the configuration of Figure 1, in some configurations, the largest profile of the most distal end of the surgical instrument is smaller than or consistent with the diameter or profile of the portion of the shaft that is intended to pass through the tissue of the patient during a surgical operation. In other words, the entirety of the pair of jaws 12A, 12B of FIG. 1 have a smaller perimeter (e.g., a smaller vertical cross sectional area) than the most distal portion of the shaft to which the pair of jaws 12A, 12B are connected. As such, the portion of the surgical instrument that first penetrates the tissue does not require a larger bore through the tissue than the portion of the shaft or body of the surgical instrument that is expected to pass through the bore.
- 12 -The portion of the edge that initiates the cutting action is dependent on the edge type. Currently, at least four different primary types of cutting edges have been developed and will be described in the context of the various embodiments illustrated herein: (1) tangential-flat; (2) tangential-bowed; (3) concentric-flat; and (4) concentric-bowed. In addition, each of the edge types can be provided with one or more edge enhancements that can be added to each edge. The edge enhancements are believed to improve cutting performance. For example, with reference to FIG. 2B, the cutting edge 20 may be enhanced by adding a spur-like protrusion 27. This protrusion causes a more torturous path for the tissue follow, which enhances the ability of the edge to cut tissue. The edge enhancements and edge rounding features described in the context of the various embodiments are not limited to those embodiments, but may be used where applicable on any of the other embodiments and in any desired combination.
The cutting edge 20 can be formed at the junction of two or more surfaces.
With reference to FIG. 1, the illustrated cutting edge 20 is defined where the outer surface 26 and the inner surface 25 intersect. The illustrated cutting edge 20 generally extends vertically while the illustrated jaws 12A, 12B open about a horizontally extending axis. Accordingly, the cutting edge 20 can extend in a direction that is perpendicular to the pivot axis of the jaws 12A, 12B. In some configurations, the cutting edge can extend in a direction that is parallel to the pivot axis of the jaws 12A, 12B. In some configurations, the cutting edge can extend in a direction that is neither parallel nor perpendicular to the pivot axis of the jaws 12A, 12B. In this and other embodiments, the full cutting edge on each jaw aligns with the cutting edge on the other jaw to create the composite cutting edge.
As described above, the cutting edge 20 can be formed along an included angle A
(see FIG. 2) that is defined by the converging surfaces 25, 26. The included angle A desirably is greater than 45 degrees. In some configurations, the included angle A is greater than 55 degrees. In some configurations, the included angle A is less than 120 degrees. In some configurations, the included angle is less than 110 degrees. In some configurations, the included angle A is between 45 degrees and
The cutting edge 20 can be formed at the junction of two or more surfaces.
With reference to FIG. 1, the illustrated cutting edge 20 is defined where the outer surface 26 and the inner surface 25 intersect. The illustrated cutting edge 20 generally extends vertically while the illustrated jaws 12A, 12B open about a horizontally extending axis. Accordingly, the cutting edge 20 can extend in a direction that is perpendicular to the pivot axis of the jaws 12A, 12B. In some configurations, the cutting edge can extend in a direction that is parallel to the pivot axis of the jaws 12A, 12B. In some configurations, the cutting edge can extend in a direction that is neither parallel nor perpendicular to the pivot axis of the jaws 12A, 12B. In this and other embodiments, the full cutting edge on each jaw aligns with the cutting edge on the other jaw to create the composite cutting edge.
As described above, the cutting edge 20 can be formed along an included angle A
(see FIG. 2) that is defined by the converging surfaces 25, 26. The included angle A desirably is greater than 45 degrees. In some configurations, the included angle A is greater than 55 degrees. In some configurations, the included angle A is less than 120 degrees. In some configurations, the included angle is less than 110 degrees. In some configurations, the included angle A is between 45 degrees and
- 13 -less than 120 degrees. In some configurations, the included angle A is within a range that has a lower boundary between 45 and 55 degrees and an upper boundary between 110 and 120 degrees. As described above, a typical surgical blade has surfaces that converge at an included angle of less than 20 degrees.
With the included angle A being greater than 45 degrees, the resulting edge is less prone to cut tissue due to axial impaction or force. More particularly, it is currently believed that an edge formed by converging surfaces that define an included angle of greater than 45 degrees will not cut tissue when pressed against the tissue under axial forces commonly encountered in surgery or through inadvertently contacting tissue. Moreover, it is currently believed that limiting the included angle to angles less than 120 degrees enables the edge to gain sufficient purchase into the tissue to effect the desired tissue removal. Thus, the included angle A preferably is large enough that the resulting edge can cut through the abdominal wall only when subjected to at least 1 pound of axial force while being rotated.
In some embodiments, when pressed in an axial direction with a standard introductory force (i.e., 1 pound) and while being rotated or torqued about the rotational or torque axis 18, the surgical instrument 10 is capable of cutting tissue due to a combination of: (1)the cutting edge 20 formed by the surfaces 25, 26 that defined the included angle A; and (2) the tissue relief areas 16 that are disposed adjacent to or contiguous with the cutting edge 20. Yet, because of the structural configuration and the angling of cutting edge 20 and the placement of the tissue relief areas 16, each of the embodiments disclosed herein is believed to be atraumatic when not presented with sufficient axial forces or when rotated without sufficient axial forces being applied.
Referring now specifically to FIG. 2A, the cutting edge 20 is formed an intersection of three distinct surfaces 23, 25, 26. As described above the inner surfaces 25 and the outer surfaces 26 can be joined together to defined the edge 20. In FIG. 2A, however, the outer portions of the outer surfaces 26 can be modified using the fillet surfaces 23 such that the fillet surfaces 23 bound the outer surfaces 26. In other words, the fillet surfaces 23 define an outer boundary
With the included angle A being greater than 45 degrees, the resulting edge is less prone to cut tissue due to axial impaction or force. More particularly, it is currently believed that an edge formed by converging surfaces that define an included angle of greater than 45 degrees will not cut tissue when pressed against the tissue under axial forces commonly encountered in surgery or through inadvertently contacting tissue. Moreover, it is currently believed that limiting the included angle to angles less than 120 degrees enables the edge to gain sufficient purchase into the tissue to effect the desired tissue removal. Thus, the included angle A preferably is large enough that the resulting edge can cut through the abdominal wall only when subjected to at least 1 pound of axial force while being rotated.
In some embodiments, when pressed in an axial direction with a standard introductory force (i.e., 1 pound) and while being rotated or torqued about the rotational or torque axis 18, the surgical instrument 10 is capable of cutting tissue due to a combination of: (1)the cutting edge 20 formed by the surfaces 25, 26 that defined the included angle A; and (2) the tissue relief areas 16 that are disposed adjacent to or contiguous with the cutting edge 20. Yet, because of the structural configuration and the angling of cutting edge 20 and the placement of the tissue relief areas 16, each of the embodiments disclosed herein is believed to be atraumatic when not presented with sufficient axial forces or when rotated without sufficient axial forces being applied.
Referring now specifically to FIG. 2A, the cutting edge 20 is formed an intersection of three distinct surfaces 23, 25, 26. As described above the inner surfaces 25 and the outer surfaces 26 can be joined together to defined the edge 20. In FIG. 2A, however, the outer portions of the outer surfaces 26 can be modified using the fillet surfaces 23 such that the fillet surfaces 23 bound the outer surfaces 26. In other words, the fillet surfaces 23 define an outer boundary
- 14 -of the outer surface 26. This combination of inner surfaces 25 meeting the surfaces 26 and the fillet surfaces 23 creating the edge 20 and the at least one cutting feature helps to decrease the likelihood of inadvertent cutting of tissue. In other words, while this combination of surfaces 23, 25, 26 creates the full cutting edge of the jaw, this combination of surfaces 23, 25, 26 also results in the outer profile of the distal most end of the surgical instrument having a rounded contour.
In the embodiment shown in Figure 2A, which is a tangent- flat type, for example, the cutting is initiated by the edge 21, which is defined by the intersection of the fillet surface 23 and the inner surface. This edge 21 is primarily tangent to an imaginary circle that is concentric to the axis of rotation 18 (with the imaginary circle demonstrated as 9 in Figure 1B) and lays within plane 4 with is perpendicular to the axis 18. Because the edge 21 primarily falls within the plane 4, the edge 21 is considered flat. The fillet surface 23 preferably is round enough to not tear the body tissue while the edge 21 is able to cut the body tissue.
Generally, the fillet surface 23 is large enough to cut, but not tear, tissue.
In summary, the cutting edge 21 in Figure 2A results from the intersection of the outer surfaces 26 and the fillet surfaces 23 on one side and from the intersection of the fillet surfaces 23 and the inner surfaces 25 on the other side. The edge preferably is sharp while all other edges around the tissue relief may be rounded.
With continued reference to FIG. 2A, the depth ofthe tissue relief 16, which is indicated by dimension Z, can be proportional to the length of the full cutting edge, which is indicated by dimension X. In some configurations, the proportionality of the dimensions Z and X defines a ratio of roughly 0.5:1.
Other ratios are possible. The width of the tissue relief 16, which is indicated as dimension Y, can be proportional to the depth of tissue relief 16, which is indicated by dimension X. In some configurations, the proportionality of the dimensions Y and X defines a ratio that is generally 1:0.5 or greater. In other words, the width can increase while the depth remains constant. These are general geometrical guides and will vary somewhat between the various embodiments.
In the embodiment shown in Figure 2A, which is a tangent- flat type, for example, the cutting is initiated by the edge 21, which is defined by the intersection of the fillet surface 23 and the inner surface. This edge 21 is primarily tangent to an imaginary circle that is concentric to the axis of rotation 18 (with the imaginary circle demonstrated as 9 in Figure 1B) and lays within plane 4 with is perpendicular to the axis 18. Because the edge 21 primarily falls within the plane 4, the edge 21 is considered flat. The fillet surface 23 preferably is round enough to not tear the body tissue while the edge 21 is able to cut the body tissue.
Generally, the fillet surface 23 is large enough to cut, but not tear, tissue.
In summary, the cutting edge 21 in Figure 2A results from the intersection of the outer surfaces 26 and the fillet surfaces 23 on one side and from the intersection of the fillet surfaces 23 and the inner surfaces 25 on the other side. The edge preferably is sharp while all other edges around the tissue relief may be rounded.
With continued reference to FIG. 2A, the depth ofthe tissue relief 16, which is indicated by dimension Z, can be proportional to the length of the full cutting edge, which is indicated by dimension X. In some configurations, the proportionality of the dimensions Z and X defines a ratio of roughly 0.5:1.
Other ratios are possible. The width of the tissue relief 16, which is indicated as dimension Y, can be proportional to the depth of tissue relief 16, which is indicated by dimension X. In some configurations, the proportionality of the dimensions Y and X defines a ratio that is generally 1:0.5 or greater. In other words, the width can increase while the depth remains constant. These are general geometrical guides and will vary somewhat between the various embodiments.
- 15 -With reference to FIG 3, a surgical instrument 30 may include an angled surface 31 located on either or both of the jaws 32A, 32B. The angled surfaces 31 may bound the cutting edges 34. In the illustrated configuration, the angled surfaces 31 extend to the distal end of the surgical instrument 30. In some configurations, the angled surfaces 31 extend to the distal ends of the jaws 32A, 32B. The angled surfaces 31 assist in directing body tissue into the tissue relief features 16 that are contiguous with the cutting edges 34. Because the angled surfaces 31 are configured to direct body tissue into the tissue relief features 16, the angled surfaces 31 need not extend the full length of the jaws. In the illustrated configuration, the angled surfaces 31 extend to a middle region along a full length of the jaws. In some configurations, the angled surfaces 31 extend between half way and the full length of the jaws. In some configurations, the angled surfaces 31 extend the full length of the jaws. In some configurations, the angled surfaces 31 extend less than half of the full length of the jaws.
Each angled surface 31 (i.e., the angled surface 31 of the top jaw 32A and the angled surface of the bottom jaw 32B) may be angled away from the grasping plane 8 of the jaws (compare with FIG. 1B). In other words, the proximal end (e.g., the end toward the shaft 22) of the angled surface 31 is spaced further from the grasping plane 8 than the distal end (e.g., the end away from shaft 22) of the angled surface 31.
The surgical instrument 30 may also include tissue relief areas 36. The tissue relief areas 36 can be positioned away from the rotational axis 38 of the surgical instrument 30 or may cross the rotational axis 38. If the tissue relief area crosses the axis of rotation 38, the tissue relief area 36 will combine to create one tissue relief between the edges 34. Of course, in the illustrated configuration, neither the tissue relief areas 36 nor the cutting edges 34 cross or intersect with the rotational axis 38.
Referring to FIG 4, an embodiment 40 of the surgical instrument demonstrates the concentric-flat type of cutting edge 44. In this embodiment, the cutting edge 44 is a concentric-flat type of cutting edge because the cutting edge 44 is concentric to
Each angled surface 31 (i.e., the angled surface 31 of the top jaw 32A and the angled surface of the bottom jaw 32B) may be angled away from the grasping plane 8 of the jaws (compare with FIG. 1B). In other words, the proximal end (e.g., the end toward the shaft 22) of the angled surface 31 is spaced further from the grasping plane 8 than the distal end (e.g., the end away from shaft 22) of the angled surface 31.
The surgical instrument 30 may also include tissue relief areas 36. The tissue relief areas 36 can be positioned away from the rotational axis 38 of the surgical instrument 30 or may cross the rotational axis 38. If the tissue relief area crosses the axis of rotation 38, the tissue relief area 36 will combine to create one tissue relief between the edges 34. Of course, in the illustrated configuration, neither the tissue relief areas 36 nor the cutting edges 34 cross or intersect with the rotational axis 38.
Referring to FIG 4, an embodiment 40 of the surgical instrument demonstrates the concentric-flat type of cutting edge 44. In this embodiment, the cutting edge 44 is a concentric-flat type of cutting edge because the cutting edge 44 is concentric to
- 16 -the imaginary circle or cylinder defined by the circle 9 and falls within the end plane 4 (see FIG. 1B, for reference). In the illustrated embodiment, the cutting edge 44 is bounded on either end by the edge 43. The edge 43 initiates the cutting action and preferably is round enough to not tear tissue. The concentric shape of the edge 44 creates a circular cut as the surgical instrument 30 is rotated about the rotational axis 48. This embodiment also has an angled surface 41 to better allow tissue to conform to the relief feature 46, which is positioned between the edge 43 and the rotational axis 48. In some configurations, the angle of the angled surface 41 is between 5 and 20 degrees relative to the clamping plane. Other configurations also are possible.
Referring to FIG 5, an embodiment 50 of the surgical instrument demonstrates the surgical instrument with a tangential-bowed type edge as the cutting edge 54.
The cutting edge 54 is tangent to an imaginary circle 9 or an imaginary cylinder defined by the circle 9. The end points of the cutting edges 54 are positioned within the end plane 4 while the middle region of the cutting edges 54 bow distally away from the end plane 4. With this type of cutting edge 54, the cutting is done primarily at the most distal part 55 of the cutting edge 54, which is where the jaws 52A, 52B meet. To enhance the cutting ability of the edge 54, a spur can be incorporated. In some configurations, the spur can be placed at location 55 to create the spur 57 (see FIG. 5B). Alternatively or in addition, a serration can be placed at location 55 (see FIG 5C). This serration creates two most distal areas 59a, 59b on the composite cutting edge. As used herein a full cutting edge is any cutting edge that defines the entire cutting feature while a composite cutting edge is a cutting feature defined by a combination of aligned cutting edges. The spurs 57 and the serrations 59a, 59b can be positioned in other locations as desired.
The embodiment of FIG. 6 demonstrates a surgical instrument 60 that has a concentric-bowed cutting edge 64. The concentric-bowed cutting edge 64 is concentric to the imaginary circle 9 or the imaginary cylinder defined by the imaginary circle. The cutting edge 64 has endpoints that are positioned within the end plane 4 while a middle portion of the cutting edge 64 bows distally out of the plane with the most distal point 66a being positioned where the jaws 62A, 62B
Referring to FIG 5, an embodiment 50 of the surgical instrument demonstrates the surgical instrument with a tangential-bowed type edge as the cutting edge 54.
The cutting edge 54 is tangent to an imaginary circle 9 or an imaginary cylinder defined by the circle 9. The end points of the cutting edges 54 are positioned within the end plane 4 while the middle region of the cutting edges 54 bow distally away from the end plane 4. With this type of cutting edge 54, the cutting is done primarily at the most distal part 55 of the cutting edge 54, which is where the jaws 52A, 52B meet. To enhance the cutting ability of the edge 54, a spur can be incorporated. In some configurations, the spur can be placed at location 55 to create the spur 57 (see FIG. 5B). Alternatively or in addition, a serration can be placed at location 55 (see FIG 5C). This serration creates two most distal areas 59a, 59b on the composite cutting edge. As used herein a full cutting edge is any cutting edge that defines the entire cutting feature while a composite cutting edge is a cutting feature defined by a combination of aligned cutting edges. The spurs 57 and the serrations 59a, 59b can be positioned in other locations as desired.
The embodiment of FIG. 6 demonstrates a surgical instrument 60 that has a concentric-bowed cutting edge 64. The concentric-bowed cutting edge 64 is concentric to the imaginary circle 9 or the imaginary cylinder defined by the imaginary circle. The cutting edge 64 has endpoints that are positioned within the end plane 4 while a middle portion of the cutting edge 64 bows distally out of the plane with the most distal point 66a being positioned where the jaws 62A, 62B
- 17 -meet. The edge enhancements discussed above also can be used in the embodiment of FIG. 6.
The embodiment of FIG. 7 demonstrates a surgical instrument 70 that has a tangential-bowed type edge. This embodiment has jaws 72A, 72B that feature a cutting edge 74 that is contiguous to a tissue relief region 76 and that is bounded by an angled surface 71. This embodiment demonstrates rounded tissue relief edges 73. In other words, the edges 73 of the tissue relief define a curved or arcuate transition to the distal-facing surface.
The embodiment of FIG 9 demonstrates a surgical instrument 80 where the cutting edges of each jaw do not align with each other (e.g., do not intersect or connect with each other). In this embodiment, the tissue relief and cutting edge remain within their respective jaws. This embodiment is used for jaws that can't have their inner grasping surface altered or impeded upon in any manner.
The embodiment of FIG 10 shows a device 90 that has a tangent-bowed edge 94 on jaws 92A, 92B that are aligned at point 94a but that do not form a composite cutting edge because it is not one aligned continuous cutting edge. This surgical instrument is for cases where the inner jaw surface features near the axis of rotation 98 must be avoided when forming, creating of providing the cutting edges 94. The configuration also creates different tissue conformity around the cutting edge 94 as the surgical instrument is rotated about the axis 98 when compared with at least some of the devices 50, 80 described above.
The embodiment of FIG. 12 shows a surgical instrument 100 that incorporates Maryland-style grasper jaws 102A, 102B. The jaws 102A, 102B include one or more angled surface 101. The angled surfaces 101 bound the cutting edge 104.
The full cutting edge includes the cutting edge 104 and the fillet edge 105.
Also demonstrated in FIG. 12 and FIG. 12B is a rounded tissue relief edge 106 that enables that area to be fully atraumatic. As with the other embodiments, this surgical instrument 100 is pushed axially along and rotated about a rotational axis 108 to cut tissue.
The embodiment of FIG. 7 demonstrates a surgical instrument 70 that has a tangential-bowed type edge. This embodiment has jaws 72A, 72B that feature a cutting edge 74 that is contiguous to a tissue relief region 76 and that is bounded by an angled surface 71. This embodiment demonstrates rounded tissue relief edges 73. In other words, the edges 73 of the tissue relief define a curved or arcuate transition to the distal-facing surface.
The embodiment of FIG 9 demonstrates a surgical instrument 80 where the cutting edges of each jaw do not align with each other (e.g., do not intersect or connect with each other). In this embodiment, the tissue relief and cutting edge remain within their respective jaws. This embodiment is used for jaws that can't have their inner grasping surface altered or impeded upon in any manner.
The embodiment of FIG 10 shows a device 90 that has a tangent-bowed edge 94 on jaws 92A, 92B that are aligned at point 94a but that do not form a composite cutting edge because it is not one aligned continuous cutting edge. This surgical instrument is for cases where the inner jaw surface features near the axis of rotation 98 must be avoided when forming, creating of providing the cutting edges 94. The configuration also creates different tissue conformity around the cutting edge 94 as the surgical instrument is rotated about the axis 98 when compared with at least some of the devices 50, 80 described above.
The embodiment of FIG. 12 shows a surgical instrument 100 that incorporates Maryland-style grasper jaws 102A, 102B. The jaws 102A, 102B include one or more angled surface 101. The angled surfaces 101 bound the cutting edge 104.
The full cutting edge includes the cutting edge 104 and the fillet edge 105.
Also demonstrated in FIG. 12 and FIG. 12B is a rounded tissue relief edge 106 that enables that area to be fully atraumatic. As with the other embodiments, this surgical instrument 100 is pushed axially along and rotated about a rotational axis 108 to cut tissue.
- 18 -The invention has been described in detail with particular reference to certain preferred embodiments thereof, but it will be understood that variations and modifications can be effected within the spirit and scope of the invention.
- 19 -
Claims (19)
1. A surgical instrument comprising:
a shaft having a proximal end and a distal end, a distally-facing surface disposed at the distal end of the surgical instrument, a rotational axis extending through the distally-facing surface at the distal end of the surgical instrument;
at least one cutting feature being positioned on the distally-facing surface at the distal end of the surgical instrument, the at least one cutting feature being formed by an edge created by at least two adjacent surfaces;
at least one tissue relief feature being positioned adjacent to the cutting feature and being partially defined by at least one of the at least two adjacent surfaces that create the edge of the at least one cutting feature, the at least one cutting feature being arranged to cut tissue when the shaft is rotated about the rotational axis while the distally-facing surface at the distal end of the surgical instrument is urged into the tissue.
a shaft having a proximal end and a distal end, a distally-facing surface disposed at the distal end of the surgical instrument, a rotational axis extending through the distally-facing surface at the distal end of the surgical instrument;
at least one cutting feature being positioned on the distally-facing surface at the distal end of the surgical instrument, the at least one cutting feature being formed by an edge created by at least two adjacent surfaces;
at least one tissue relief feature being positioned adjacent to the cutting feature and being partially defined by at least one of the at least two adjacent surfaces that create the edge of the at least one cutting feature, the at least one cutting feature being arranged to cut tissue when the shaft is rotated about the rotational axis while the distally-facing surface at the distal end of the surgical instrument is urged into the tissue.
2. The surgical instrument of claim 1, wherein the surgical instrument comprises a first jaw and a second jaw, at least one of the first jaw and the second jaw being moveably connected to the shaft, the distally-facing surface at the distal end of the surgical instrument comprising a distal end of at least one of the first jaw and the second jaw.
3. The surgical instrument of claim 2, wherein an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle is within a range of 45 to 120 degrees.
4. The surgical instrument of claim 2, wherein an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle being greater than 45 degrees.
5. The surgical instrument of claim 4, wherein the included angle is greater than 55 degrees.
6. The surgical instrument of claim 2, wherein an included angle is formed between the at least two adjacent surfaces forming the edge of the at least one cutting feature and the included angle is large enough that the resulting edge can cut through the abdominal wall only when subjected to at least 1 pound of axial force while being rotated.
7. The surgical instrument of claim 2, wherein a shape of the edge of the at least one cutting feature is a linear edge that extends tangential to a circle that is centered on the rotational axis while the linear edge also is within a plane that is perpendicular to the rotational axis.
8. The surgical instrument of claim 7, wherein the edge extends in a first direction and at least one jaw pivots about a pivot axis, the pivot axis extending perpendicular to the first direction.
9. The surgical instrument of claim 7, wherein the at least one cutting feature is defined by three distinct surfaces, the three distinct surfaces comprising an inner surface, an outer surface that converges with the inner surface, and a fillet surface that forms an outer boundary of the outer surface.
10. The surgical instrument of claim 2, wherein a shape of the edge of the at least one cutting feature is concentric to the rotational axis while also being positioned within a plane that is perpendicular to the rotational axis.
11. The surgical instrument of claim 2, wherein a shape of the edge of the at least one cutting feature is concentric to the rotational axis while the edge bows outwardly in a distal direction out of a plane that is perpendicular to the rotational axis.
12. The surgical instrument of claim 2, wherein a shape of the edge of the at least one cutting feature is a straight edge that extends tangential to a circle that is centered on the rotational axis while the edge bows outwardly in a distal direction out of a plane that is perpendicular to the rotational axis.
13. The surgical instrument of claim 2, wherein the edge of the at least one cutting feature does not cross the rotational axis.
14. The surgical instrument of claim 2, wherein the edge of the at least one cutting feature is bounded at each end by a planar surface that is angled such that a distal portion of the planar surface is closer to the rotational axis than a proximal portion of the planar surface.
15. The surgical instrument of claim 14, wherein the planar surface has an incline angle of between 5 and 20 degrees.
16. The surgical instrument of claim 14, wherein the angled surface is oriented perpendicular to the edge of the at least one cutting feature.
17. The surgical instrument of claim 2, wherein the at least one cutting feature is enhanced with a spur-like feature.
18. The surgical instrument of claim 2, wherein the at least one cutting feature is enhanced with a serration-like feature.
19. The surgical instrument of claim 2, wherein the at least one tissue relief feature comprises a rounded tissue relief edge that is positioned away from the edge of the at least one cutting edge.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201562260112P | 2015-11-25 | 2015-11-25 | |
| US62/260,112 | 2015-11-25 | ||
| PCT/US2016/062549 WO2017091445A1 (en) | 2015-11-25 | 2016-11-17 | Surgical instrument for penetration of tissue layers |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA3006045A1 true CA3006045A1 (en) | 2017-06-01 |
Family
ID=58763541
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA3006045A Pending CA3006045A1 (en) | 2015-11-25 | 2016-11-17 | Surgical instrumentfor penetration of tissue layers |
Country Status (4)
| Country | Link |
|---|---|
| CN (1) | CN108289696B (en) |
| CA (1) | CA3006045A1 (en) |
| HK (1) | HK1254655A1 (en) |
| WO (1) | WO2017091445A1 (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2553664B (en) * | 2016-09-12 | 2018-11-14 | Chao Stan | Fascia cutting and spreading instrument for use in laparoscopy |
Family Cites Families (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5226426A (en) * | 1990-12-18 | 1993-07-13 | Inbae Yoon | Safety penetrating instrument |
| US6083237A (en) * | 1998-10-23 | 2000-07-04 | Ethico Endo-Surgery, Inc. | Biopsy instrument with tissue penetrating spiral |
| DE10007919C2 (en) * | 2000-02-21 | 2003-07-17 | Wolf Gmbh Richard | Forceps for free preparation of tissue in a body cavity |
| US8398666B2 (en) * | 2000-05-16 | 2013-03-19 | Teleflex Medical Incorporated | Penetrating tip for trocar assembly |
| US6966774B2 (en) * | 2001-08-16 | 2005-11-22 | Cloudland Institute, Llc. | Endodontic instrument having notched cutting surfaces |
| FR2887153B1 (en) * | 2005-06-20 | 2008-04-04 | Alain Villette | INJECTION NEEDLE |
| CA2781046C (en) * | 2009-12-02 | 2014-09-16 | Tyco Healthcare Group Lp | Methods and devices for cutting tissue |
| EP2765930B1 (en) * | 2011-10-13 | 2018-09-26 | Atheromed, Inc. | Atherectomy apparatus |
-
2016
- 2016-11-17 CA CA3006045A patent/CA3006045A1/en active Pending
- 2016-11-17 WO PCT/US2016/062549 patent/WO2017091445A1/en active Application Filing
- 2016-11-17 CN CN201680069240.4A patent/CN108289696B/en active Active
-
2018
- 2018-10-24 HK HK18113623.8A patent/HK1254655A1/en unknown
Also Published As
| Publication number | Publication date |
|---|---|
| WO2017091445A1 (en) | 2017-06-01 |
| CN108289696B (en) | 2021-03-19 |
| HK1254655A1 (en) | 2019-07-26 |
| CN108289696A (en) | 2018-07-17 |
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