CN103429182A

CN103429182A - Surgical instrument with jaw member

Info

Publication number: CN103429182A
Application number: CN2011800578675A
Authority: CN
Inventors: M·A·戴维森; C·P·鲍德雷奥克斯; S·B·基林格; J·T·巴特罗斯; J·R·乔达诺; G·A·特里斯; B·王; A·C·沃格勒; D·K·诺维尔; N·F·巴贝拉; K·D·费尔德
Original assignee: Ethicon Endo Surgery Inc
Current assignee: Ethicon Endo Surgery Inc
Priority date: 2010-10-01
Filing date: 2011-09-27
Publication date: 2013-12-04
Anticipated expiration: 2031-09-27
Also published as: CA2813389A1; RU2581715C2; CA2813389C; EP2621390A2; AU2011307338B2; WO2012044606A3; AU2011307338A8; AU2011307338B8; RU2013120005A; JP2013541988A; JP5905472B2; AU2011307338A1; BR112013007879A2; WO2012044606A2; CN103429182B

Abstract

A surgical instrument for supplying energy to tissue may comprise a handle, a trigger, an electrical input, and a shaft extending from the handle. The surgical instrument may comprise and end effector first and second tissue engaging surfaces that are slanted with respect to a transection plane. The end effector may, for example, have an electrode defining a V-shaped cross sectional profile. The end effector may comprise a plurality of raised surfaces that are received by a plurality of indentions when the end effector is in the closed position. The end effector may comprise a cutting member having a plurality of bands. A surgical instrument for supplying energy to tissue may comprise a handle, a trigger, an electrical input, and a shaft extending from the handle. The surgical instrument may comprise an end effector. The end effector may comprise a cammed compression surface. The end effector may comprise an electrode comprising a tapered tissue contacting surface. Some surgical instruments may comprise an overload member.

Description

Surgical instruments with jaw member

Background technology

In all cases, surgical instruments can apply energy in order to process and/or destroy this tissue to tissue.In some cases, surgical instruments can comprise one or more electrodes, and described electrode can, against tissue positioned and/or with respect to tissue positioned, make electric current can flow through this electrode and flow in tissue.The power supply conductor that described surgical instruments also can comprise electrical input, electrically connect with electrode and/or return to conductor, this returns to conductor and can for example allow electric current to flow through power supply conductor from electrical input, flow through electrode and tissue, then flow through and return to conductor, flow to electric outfan.In all cases, energy can produce heat to form one or more hemostatic seal in tissue in institute's capture tissue.This type of embodiment can be particularly useful for for example seal blood vessels.Described surgical instruments also can comprise cutting element, and described cutting element can be with respect to tissue and electrode movement, so that transecting patient tissue.

Above-mentioned discussion is just to illustrating the current various aspects of correlation technique in technical field of the present invention, and should not be considered as to the claim scope, negate.

Summary of the invention

According to various embodiment, for the surgical instruments that energy is provided to tissue, can comprise shank.Shank can comprise trigger, electrical input and the axle extended from shank.Axle can comprise conductor.Trigger can be can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise the end effector that limits longitudinal axis and cross-table.End effector can comprise the first jaw member and the second jaw member.At least one in the first jaw member and the second jaw member can be with respect to the motion of the another one in the first jaw member and the second jaw member, to clamp the middle tissue of the first jaw member and the second jaw member.End effector also can comprise that the electrode and first electrically connected with conductor organizes composition surface and second to organize composition surface, and described first organizes composition surface and second to organize composition surface to be connected to one in the first jaw member and the second jaw member and Axis Extension longitudinally.First to organize composition surface and second to organize each in composition surface all can have inside and outside, wherein first organize composition surface and second organize composition surface with respect to cross-table for tilting.

According to various embodiment, for the surgical instruments that energy is provided to tissue, can comprise shank.Shank can comprise trigger and electrical input.Axle can extend from shank, and its axis comprises conductor, and wherein trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise end effector, and described end effector limits longitudinal axis and comprises the first jaw member and the second jaw member.At least one in the first jaw member and the second jaw member can move with respect to the another one in the first jaw member and the second jaw member between open position and make position, to clamp the middle tissue of the first jaw member and the second jaw member when in the close position.The active electrode that end effector can comprise the passive electrode with passive electrode tissue contacting surface and have the first active electrode tissue contacting surface and the second active electrode tissue contacting surface.Active electrode can electrically connect with conductor, and the first active electrode tissue contacting surface can be roughly parallel to the passive electrode tissue contacting surface when in the close position.When in the close position, the second active electrode tissue contacting surface can be roughly with respect to the passive electrode tissue contacting surface.

According to various embodiment, can comprise shank for the surgical instruments that energy is provided to tissue, described shank comprises trigger and electrical input.Surgical instruments can comprise the axle extended from shank, and wherein said axle comprises conductor, and wherein trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise the end effector that limits longitudinal axis.End effector can comprise the first jaw member and the second jaw member.At least one in the first jaw member and the second jaw member can move with respect to the another one in the first jaw member and the second jaw member between open position and make position, to clamp the middle tissue of the first jaw member and the second jaw member when in the close position.End effector also can comprise the first electrode connected with conductor.The first electrode can comprise a plurality of convex surfaces.When in the close position, tissue contacting surface can be relative with the first electrode, and wherein tissue contacting surface can limit a plurality of indentures.Indenture can be oriented to hold a plurality of convex surfaces when in the close position when the first jaw member and the second jaw member.

According to various embodiment, for the surgical instruments that energy is provided to tissue, can comprise trigger, electrical input and the axle extended from shank.Axle can comprise conductor, and trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments also can comprise the end effector that limits longitudinal axis.End effector can comprise the first jaw member and the second jaw member.At least one in the first jaw member and the second jaw member can move with respect to the another one in the first jaw member and the second jaw member between open position and make position, to clamp the middle tissue of the first jaw member and the second jaw member when in the close position.The first jaw member and the second jaw member can limit passage.End effector can comprise the cutting element with far-end, and wherein the size of cutting element and structure are configured to be assemblied in passage at least in part.Cutting element can be at advanced position and is advanced fully between position along the passage translation.Cutting element can comprise at least the first band, the second band and the 3rd band, and wherein the second band is arranged on the centre of the first band and the 3rd band and comprises sharp keen distal incision element.End effector also can comprise at least one compressing member extended from cutting element, and wherein at least one compressing member engages one in the first jaw and the second jaw to make the first jaw and the second jaw move to make position from open position when cutting element moves to outside advanced position with respect to the first jaw member.

According to various embodiment, for the surgical instruments that energy is provided to tissue, can comprise shank, trigger, electrical input and the axle extended from shank.Axle can comprise conductor, and trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise the end effector that limits longitudinal axis.End effector can comprise the first jaw member and the second jaw member, described the first jaw member comprises the longitudinally cam compressive surfaces of axis, wherein at least one in the first jaw member and the second jaw member can move with respect to the another one in the first jaw member and the second jaw member between open position and make position, to clamp the middle tissue of the first jaw member and the second jaw member when in the close position.The first jaw member and the second jaw member can limit passage.End effector can comprise the cutting element with far-end, and wherein the size of cutting element and structure are configured to be assemblied in passage at least in part.Cutting element can be at advanced position and is advanced fully between position along the passage translation.End effector can comprise from cutting element and extending and at least one compressing member of contact cam compressive surfaces, and wherein said at least one compressing member engagement cam compressive surfaces to make the first jaw and the second jaw move to make position from open position when cutting element moves to outside advanced position with respect to the first jaw member and the second jaw member.

According to various embodiment, for the surgical instruments that energy is provided to tissue, can comprise shank, trigger and electrical input.Surgical instruments can comprise the axle extended from shank, and its axis comprises conductor, and wherein trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise the end effector that limits longitudinal axis.End effector can comprise the first jaw member and the second jaw member, and described the first jaw member comprises the longitudinally cam compressive surfaces of axis.At least one in the first jaw member and the second jaw member can move with respect to the another one in the first jaw member and the second jaw member between open position and make position, to clamp the middle tissue of the first jaw member and the second jaw member when in the close position.The first jaw member and the second jaw member can limit passage.End effector also can comprise the cutting element with far-end, and wherein the size of cutting element and structure are configured to be assemblied in passage at least in part.Cutting element can be at advanced position and is advanced fully between position along the passage translation, and wherein cutting element limits cross-table.End effector also can comprise the electrode with taper tissue contacting surface.

According to various embodiment, can comprise shank for the surgical instruments that energy is provided to tissue, described shank comprises trigger, operatively is connected to overload member and the electrical input of trigger.Surgical instruments also can comprise the axle extended from shank, and its axis comprises conductor, and wherein trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise end effector, and described end effector limits longitudinal axis and comprises the first jaw member and the second jaw member.At least one in the first jaw member and the second jaw member can be with respect to the motion of the another one in the first jaw member and the second jaw member, to clamp the middle tissue of the first jaw member and the second jaw member.End effector also can comprise the electrode electrically connected with conductor.

According to various embodiment, for the surgical instruments that energy is provided to tissue, can comprise shank, trigger, electrical input and the axle extended from shank.Axle can comprise conductor, and trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise the end effector that limits longitudinal axis.End effector can comprise the first jaw member and the second jaw member, and described the first jaw member comprises the longitudinally cam compressive surfaces of axis.At least one in the first jaw member and the second jaw member can move with respect to the another one in the first jaw member and the second jaw member between open position and make position, to clamp the middle tissue of the first jaw member and the second jaw member when in the close position.The first jaw member and the second jaw member can limit passage.End effector can comprise the cutting element with far-end, and wherein the size of cutting element and structure are configured to be assemblied in passage at least in part.Cutting element can be at advanced position and is advanced fully between position along the passage translation.Cutting element can comprise the first compressing member and the second compressing member be spaced a distance.The first compressing member can be and can join the first jaw member and the second compressing member to and can be and can join the second jaw member to, and wherein the first compressing member can move with respect to cutting element.

The accompanying drawing explanation

The various structures of embodiment as herein described have been described in detail in appended claims.Yet, according to the following description in conjunction with following accompanying drawing, be appreciated that various embodiment (being all like this) are together with its advantage concerning the organization and method of operation.

Fig. 1 is the perspective view according to the surgical instruments shown at least one embodiment.

The side view of the shank of the surgical instruments that Fig. 2 is Fig. 1, half that has wherein removed the shank main body is to illustrate some assemblies in it.

The perspective view of the end effector of the surgical instruments that Fig. 3 is Fig. 1, it is depicted as in opening configuration; The far-end of closed beam is depicted as in advanced position.

The perspective view of the end effector of the surgical instruments that Fig. 4 is Fig. 1, it is depicted as in closed configuration; The far-end of closed beam is depicted as in part and advances position.

The perspective cut-away schematic view of the part of the end effector of the surgical instruments that Fig. 5 is Fig. 1.

Fig. 6 is the cutaway view according to the end effector of a non-limiting example.

Fig. 6 A illustrates according to first jaw when end effector is in the close position of a non-limiting example and the interactional cutaway view between the second jaw.

Fig. 7 is the amplification view that is illustrated in the first jaw of the end effector in Fig. 6.

Fig. 7 A is the toothed zoomed-in view in Fig. 7 that is illustrated according to a non-limiting example.

Fig. 8 is the zoomed-in view according to the end effector of a non-limiting example.

Fig. 8 A is the zoomed-in view that is illustrated in the portions of proximal of the first jaw in Fig. 8.

Fig. 9 is the amplification view that is illustrated in the second jaw of the end effector in Fig. 6.

The zoomed-in view of the part that Fig. 9 A is Fig. 9.

Figure 10 is the profile perspective according to the end effector in conjunction with offset electrode of a non-limiting example.

Figure 11 shows the end effector according to a non-limiting example.

Figure 11 A is the zoomed-in view of distal part that is illustrated in the second jaw of the end effector in Figure 11.

Figure 12 is the fragmentary, perspective view according to the first jaw of the end effector of Figure 11 of a non-limiting example.

Figure 13 A and 13B are the cross-sectional side view of far-end during two kinds of modes of operation that is illustrated in the end effector in Figure 11.

Figure 14 shows the end effector in conjunction with the electrode of magnificent husband's pattern that has according to a non-limiting example.

Figure 15 shows the tissue contacting surface according to first jaw that is illustrated in the end effector in Figure 14 of a non-limiting example.

Figure 16 shows the far-end according to the movable cutting element of a non-limiting example.

Figure 17 for can with the view of the far-end of the end effector used together with movable cutting element in being illustrated in Figure 16.

Figure 18 is the cutaway view according to the end effector in an open position of a non-limiting example.

Figure 19 and 20 show shown in Figure 18 at the first jaw end effector after the second jaw pivotable.

Figure 21 is the profile according to the first closure pin track of a non-limiting example.

Figure 22 is the cutaway view according to the jaw of a non-limiting example.

Figure 23 A and 23B show and are attached to the closure pin of movable cutting element according to a non-limiting example in two kinds of mode of operation processes.

Figure 24 shows the movable cutting element with translation band according to a non-limiting example.

Figure 25 shows the movable cutting element of Figure 24 between retraction/return period.

Figure 26 and 28 cutaway views for the trigger shaft that operatively is connected to pushing block according to a non-limiting example.

Figure 27 and 29 is the perspective view according to the movable cutting element of a non-limiting example.

Figure 30 is the decomposition diagram of the movable cutting element that comprises the closure pin assembly according to a non-limiting example.

The perspective view of the movable cutting element that Figure 31 is the Figure 30 in assembled configuration.

The cutaway view of the movable cutting element that Figure 31 A is Figure 31.

Figure 32 is the exploded view of the closure pin that comprises needle bearing according to a non-limiting example.

The cutaway view of the closure pin through assembling that Figure 33 is Figure 32.

Figure 34 is the perspective view according to the end effector of a non-limiting example.

Figure 35 is the cutaway view that is illustrated in the part of the end effector in Figure 34.

Figure 36 shows the step pin according to a non-limiting example.

Figure 37 A and 37B show the tyre according to the movable cutting element of a non-limiting example.

Figure 38 A and 38B show the tyre in Figure 33 of assembling position A and 33B.

The perspective view of the top far-end that Figure 39 is the movable cutting element after attached the first jaw closure pin.

Figure 40 shows the shear pin according to a non-limiting example.

Figure 41 shows the simple version according to the trigger assembly that comprises shear pin of a non-limiting example.

Figure 42 shows the surgical instruments according to a non-limiting example, has wherein removed the part of shell so that a plurality of intrawares to be shown.

The zoomed-in view of the part that Figure 43 is trigger assembly, wherein for clarity sake removed a plurality of assemblies.

The exploded view of a plurality of assemblies of the trigger assembly that Figure 44 is Figure 43, wherein for clarity sake removed a plurality of assemblies.

Figure 45 shows the compression element according to the inside of the driving shaft that is installed to surgical instruments of a non-limiting example.

The cutaway view that Figure 45 A is Figure 45.

In described a plurality of views, corresponding reference marks means corresponding parts.Example shown in this paper shows various embodiment of the present invention with a kind of form, this example should be interpreted as to be to limit the scope of the invention by any way.

The specific embodiment

Various embodiment relate to equipment, the system and method for the treatment of tissue.Show many specific details, thereby obtain described in description and the thorough understanding of overall structure, function, manufacture and purposes of the embodiment shown in accompanying drawing.Yet it will be understood to those of skill in the art that can be in the situation that do not have such specific detail to implement described embodiment.In other example, do not describe operation, assembly and the element of knowing in detail, in order to avoid make the embodiment described in description smudgy.Those of ordinary skills will be understood that, described herein and shown in embodiment be non-limitative example, and therefore can recognize, ad hoc structure disclosed herein and function detail may be representational, and needn't limit the scope of embodiment, the scope of embodiment only is defined by the following claims.

" the various embodiment " that this description is quoted in the whole text, " some embodiment ", " embodiment " or " embodiment " etc., refer to that specific features, structure or the characteristic described in conjunction with described embodiment comprise at least one embodiment.Therefore, the phrase " in various embodiments " that this description occurs in the whole text, " in certain embodiments ", " in one embodiment " or " in an embodiment " etc. might not all refer to identical embodiment.In addition, in one or more embodiments, specific features, structure or characteristic can combine in any suitable way.Therefore, in unconfined situation, the specific features that illustrates or describe in conjunction with an embodiment, structure or characteristic can be combined with feature, structure or the characteristic of one or more other embodiment whole or in part.

Should be appreciated that can handle the end be used in the apparatus for the treatment of the patient in conjunction with the clinician uses term " nearside " and " distally " in the whole text in description.Term " nearside " refers to the most close clinician's the part of apparatus, and term " distally " refers to from the clinician part farthest.It is also understood that for simple and clear and clear for the purpose of, this paper can be with reference to illustrated embodiment usage space term for example " vertically ", " level ", "up" and "down".Yet surgical instruments can be used in multiple directions and position, and these terms are not meant to be restrictive and absolute.

Whole disclosures of following non-provisional United States Patent (USP) are incorporated herein by reference accordingly:

United States Patent (USP) 7,381,209, name is called ELECTROSURGICAL INSTRUMENT;

United States Patent (USP) 7,354,440, name is called ELECTROSURGICAL INSTRUMENT AND METHOD OF USE;

United States Patent (USP) 7,311,709, name is called ELECTROSURGICAL INSTRUMENT AND METHOD OF USE;

United States Patent (USP) 7,309,849, name is called POLYMER COMPOSITIONS EXHIBITING A PTC PROPERTY AND METHODS OF FABRICATION;

United States Patent (USP) 7,220,951, name is called SURGICAL SEALING SURFACES AND METHODS OF USE;

United States Patent (USP) 7,189,233, name is called ELECTROSURGICAL INSTRUMENT;

United States Patent (USP) 7,186,253, name is called ELECTROSURGICAL JAW STRUCTURE FOR CONTROLLED ENERGY DELIVERY;

United States Patent (USP) 7,169,146, name is called ELECTROSURGICAL PROBE AND METHOD OF USE;

United States Patent (USP) 7.125.409, name is called ELECTROSURGICAL WORKING END FOR CONTROLLED ENERGY DELIVERY; With

United States Patent (USP) 7,112,201, name is called ELECTROSURGICAL INSTRUMENT AND METHOD OF USE.

The various embodiment of these system and methods relate to formation heat " welding " or " fusion " in the natural fabric piece.The alternative terms of tissue " welding " and tissue " fusion " is used interchangeably in this article, to describe, the destination organization piece is heat-treated, thereby produce the piece of tissue fused together uniformly substantially, in the blood vessel of for example welding, post processing shows stronger rupture strength immediately.The intensity of this type of welding especially can be used for (i) sealed-for-life blood vessel in blood vessel crosscut operation; (ii) welding organ edge in resection operation; (iii) welding wherein needs other dissection conduit of permanent closure; And other operation that (iv) can be used for carrying out angiostomy, vessel sealing art or anatomical structure or its part are bonded together in addition.Tissue welding disclosed herein or fusion are different from " condensing ", " hemostasis " and are usually directed to other the similar descriptive term that reduces and block the blood flow in little blood vessel or blood vessel tissue.For example, apply heat energy to any surface and all may cause condensing or stopping blooding, but do not belong to the category of term used herein " welding ".This type of surface condensation can not produce the welding of organizing any remarkable intensity that processing is provided.

At molecular level, the phenomenon of real " welding " tissue may come from the degeneration of collagen and other protein molecular in the destination organization piece caused by heat as disclosed herein, with formation transient state liquid state or gel protein mixture.Selected energy density is provided in destination organization, can makes in the molecule in collagen and other oroteins and the crosslinked hydrothermal decomposition of intermolecular hydrogen bonding.The protein mixture of degeneration is remained on to selected hydration levels (not dewatering) in can be very short selected interval.Keep the mechanical compress state of destination organization piece in selected very high degree, closer to each other with the denatured protein of guaranteeing to unwind, in order to interweaved and tangled.When hot relaxation, with the generation of crosslinked and renaturation again, the protein mixture mixed tangles protein, thereby produces the block evenly fused together.

Surgical instruments can be for example provides energy to patient's tissue, for example electric energy, ultrasonic energy and/or heat energy.For example, various embodiment disclosed herein provides following Electrosurgical forceps mouth structure, described Electrosurgical forceps mouth structure is suitable for the tissue of catching between the crosscut jaw, and is suitable for by controllably applying radio-frequency (RF) energy the edge of welding simultaneously or sealing institute capture tissue.Surgical instruments can also clamp, cut-out and suture tissue.

In more detail, in various embodiments, referring now to Fig. 1, show electrosurgical unit 100.Surgical instruments or electrosurgical unit 100 can comprise nearside shank 105, distal working or end effector 110 and be arranged between the two and shank 105 operatively is connected to conductor or the slender axles 108 of end effector 110 at least partly.End effector 110 can comprise one group can open/closeable jaw, have straight or crooked jaw-top the first jaw 120A and bottom the second

jaw 120B.Jaw

120A and 120B can be linked together with being operated, make the first jaw 120A to move between open position and make position with respect to the second jaw 120B.The first jaw 120A and the second jaw 120B can comprise that the elongated slot that outwards arranges respectively along they corresponding mid portions or passage 142A and 142B(are referring to Fig. 3 separately).The first jaw 120A and the second jaw 120B can be connected to by the electrical lead in cable 152 power supply 145 and controller 150.Controller 150 can be used for starting power supply 145.In various embodiments, power supply 145 can comprise for example electric energy of radio frequency source, ultrasound source, DC source and/or any other suitable type.

Forward now Fig. 2 to, it shows the side view of shank 105, and wherein the first shank main body 106A(is referring to Fig. 1) half be removed to illustrate some assemblies in the second shank main body 106B.Shank 105 can comprise from lever arm or the trigger 128 of shank main body 106A and/or 106B extension.Can be along path 129 tractive triggers 128, make trigger 128 with respect to main body 106A and/or 106B motion.Trigger 128 also can operatively be connected to the movable cutting element 140 be arranged in slender axles 108 by reciprocating part 146, and described reciprocating part operatively joins the extension 127 of trigger 128 to.Therefore, the motion of the relative shank main body 106A of trigger 128 and/or 106B can make cutting element 140 with respect to jaw 120A and 120B(referring to Fig. 1) in the one or both translation.In addition, as described in more detail below, cutting element 140 can be with closed beam 170(referring to Fig. 3-4) engage releasedly, described closed beam also with jaw 120A, 120B is associated movingly.Reciprocating part 146 also can be connected to bias unit, for example spring 141, described bias unit also can be connected to the second shank main body 106B with biasing reciprocating part 146 therefore setover cutting element 140 and/or closed beam 170(Fig. 3), thereby jaw 120A and 120B are pressed to open position, as shown in Figure 1.In addition, referring to Fig. 1 and 2, locking component 131(is referring to Fig. 2) can be by locking switch 130(referring to Fig. 1) between latched position and unlocked position, move, in this latched position, basically prevent that as shown in the figure reciprocating part 146 is towards distal movement, at this unlocked position, can allow reciprocating part 146 freely to move towards slender axles 108 along distal direction.Shank 105 can be the pistol grip of any type or the shank of other type as known in the art, and it can carry actuator lever, trigger or sliding part, with for activating the first jaw 120A and the second jaw 120B.Slender axles 108 can have cylindrical or rectangular cross section, and can comprise the thin-walled tubular sleeve extended from shank 105.Slender axles 108 can comprise the hole of running through extension, with for example, for the carrying actuator mechanism (cutting element 140 and/or closed beam 170) for activating jaw for example, and for carrying by energy delivery the electrical lead to the electrosurgery assembly of end effector 110.

End effector 110 can be suitable for catching, welding or seal and transecting patient tissue.The first jaw 120A and the second jaw 120B can be closed to catch or joining tissue around the longitudinal axis 125 limited by cutting element 140 thus.The first jaw 120A and the second jaw 120B also can apply compression to tissue.Slender axles 108, together with the first jaw 120A and the second jaw 120B, can rotate 360 complete degree with respect to shank 105 by for example rotating triple contacts, as shown in arrow 117.The first jaw 120A and the second jaw 120B can remain and can open and/or closeable in rotation.In certain embodiments, can handle hoop 119 or other rotating control assembly so that end effector 110 rotations by user.

Fig. 3 and 4 shows the perspective view of end effector 110.End effector 110 and Fig. 4 that Fig. 3 shows in opening configuration show the end effector 110 in closed configuration.As mentioned above, end effector 110 can comprise top the first jaw 120A and bottom the second jaw 120B.In addition, the first jaw 120A and the second jaw 120B can have the grip element of organizing on the inside that is arranged on the first jaw 120A and the second jaw 120B separately, and for example tusk 143.The first jaw 120A can comprise for example top the first jaw main body 161A, and described top the first jaw main body has top first and sends surperficial 175A to top first energy of outer surface 162A and the first electrode.The second jaw 120B can comprise for example bottom the second jaw main body 161B, and described bottom the second jaw main body has bottom second and sends surperficial 175B to bottom second energy of outer surface 162B and the second electrode.The first energy is sent surperficial 175A and the second energy and is sent surperficial 175B and all can extend with " U " shape around the far-end of end effector 110.Energy is sent

surperficial

175A, and 175B can be provided for contact, grasp and/or handle the tissue contacting surface of tissue between the two.

Referring to Fig. 3-5, at least one embodiment, the size of closed beam 170 and cutting element 140 and structure can be set in the passage 142A that is assemblied at least in part the first jaw 120A.As shown in Figure 5, the size of cutting element 140 and structure also can be set in the passage 142B that is assemblied at least in part the second jaw 120B.Under any circumstance, closed beam 170 and cutting element 140 can be along passage 142A the translation first, between advanced position and second, propelling position, described first, advanced position is relevant to the first jaw (Fig. 3) in an open position, described second, advance position relevant to the second jaw (referring to for example Fig. 4) in the close position.The trigger 128(of shank 105 is referring to Fig. 2) can be suitable for activating cutting element 140 and activate subsequently the closed beam 170 that also is used as the jaw close mechanism.For example, when along path 129 during towards nearside tractive trigger 128, can be via reciprocating part 146 towards distally pushing cutting element 140 and/or closed beam 170, as shown in Figure 2 and as mentioned above.Cutting element 140 and closed beam 170 can comprise one or more parts separately, but under any circumstance, can be separately with respect to slender axles 108 and/or jaw 120A, 120B motion or translation.In addition, at least one embodiment, cutting element 140 can for example be made by the 17-4 precipitation-hardening stainless steel.In one embodiment, at least a portion of cutting element 140 is 716 rustless steels.The distal part of cutting element 140 can comprise flanged " I " ellbeam, in the passage 142A that it can be in jaw 120A and 120B and 142B, slides.In at least one embodiment, the distal part of closed beam 170 can comprise " C " ellbeam, and it can slide in the one in passage 142A and 142B.As in Figure 3-5, within closed beam is depicted as the passage 142A that is positioned at the first jaw 120A and/or on.Closed beam 170 can slide for example to carry out open and close the first jaw 120A with respect to the second jaw 120B in passage 142A.The distal part of closed beam 170 also can limit cam face 174, with for for example engage the first jaw 120A to outer surface 162A.Therefore, when closed beam 170 is advanced to the second position (Fig. 4) through passage 142A from for example primary importance (Fig. 3) towards distally, the first jaw 120A can be forced into to closed (Fig. 4).Also can be by the closed beam 170 of upper wall 165 guiding of the first jaw 120A, as shown in Figure 5, described upper wall can be sealed closed beam 170 at least in part.For clarity sake, from Fig. 3-4, omitted upper wall 165.

In addition, in various embodiments, the size of cutting element 140 and structure can be set assembling at least in part for or slide in closed beam 170, for example, in the inner passage 171 of closed beam 170.In at least one embodiment, as shown in Figure 5, although the parts of cutting element 140 can be positioned in closed beam 170, the part of cutting element 140 can be outstanding from closed beam 170 along the direction of the longitudinal axis 172 transverse to being limited by closed beam 170.Flange 144A and the 144B of cutting element 140 can limit interior cam surface, with the inner passage 171 for engaging closed beam 170 and the second jaw 120B to outer surface 162B.As described in more detail below, the open and close of

jaw

120A and 120B can be utilized cam mechanism and

jaw

120A, 120B to

outer surface

162A, 162B is applied to tissue by high compression stress, cam mechanism can comprise reciprocating " C ellbeam " closed beam 170 and/or " I ellbeam " cutting element 140.

More particularly, still referring to Fig. 3-5, the flange 144A of the far-end of cutting element 140 and 144B can jointly be suitable for engaging slidably respectively the inner passage 171 of closed beam 170 and the second jaw 120B second to outer surface 162B.Passage 142A in the first jaw 120A and the size of the passage 142B in the second jaw 120B and structure can be set the motion that adapts to closed beam 170 and/or cutting element 140 for, described cutting element can comprise organizes cutting element, for example sharp keen distal side edge and/or surface.For example, Fig. 4 shows the far-end 178 of the closed beam 170 advanced through passage 142A at least in part.Advance closed beam 170 end effector 110 can be closed into to the closed configuration shown in Fig. 4 from the configuration of opening shown in Fig. 3.Closed beam 170 can be along passage 142A first, advanced position and second, fully advance between position and move or translation.Advanced position can be as shown in Figure 3, jaw 120A wherein, and the in an open position and far-end 178 closed beam 170 of 120B is oriented to adjacent upper portions to outer surface 162A.Although not shown, when the far-end 178 of closed beam 170 is advanced to the far-end 164 of passage 142A and jaw when in the close position, can form and advance position fully, referring to Fig. 4.Equally, cutting element 140(Fig. 5) can with respect to the first jaw advanced position with advance position translation fully, jaw 120A in advanced position, 120B (Fig. 3) in an open position, in advancing position fully, cutting element is advanced to for example far-end 164 of passage 142A, wherein jaw (Fig. 4) in the close position.As mentioned above, when closed beam 170, through jaw 120A, when 120B advances, cutting element 140 also can be with respect to closed beam 170 translations.

In at least one embodiment, the distal part of closed beam 170 and cutting element 140 can be positioned in the jaw 120A of end effector 110 and inside and/or near the distally and/or slender axles 108 of the one or both in 120B.In addition, in the make position shown in Fig. 4, the first energy that top the first jaw 120A and bottom the second jaw 120B limit respectively the first jaw 120A is sent the second energy of surperficial 175A and the second jaw 120B and is sent gap or the dimension D between surperficial 175B.Dimension D for example can equal approximately 0,0005 " to approximately 0,040 ", and for example can equal in certain embodiments approximately 0,001 " to approximately 0,010 ".In addition, the first energy is sent surperficial 175A and the second energy and is sent the edge of surperficial 175B and can be arranged to circular to prevent incised tissue.

Referring now to Fig. 1 and 3,, end effector 110 can be connected to power supply 145 and controller 150.The first energy is sent surperficial 175A and the second energy and is sent surperficial 175B and can be connected to separately power supply 145 and controller 150 equally.The first energy send surperficial 175A and the second energy send surperficial 175B can contact tissue and the electrosurgical energy that will be suitable for sealing or weld structure be delivered to the tissue of joint.The electric energy that controller 150 scalable are sent by power supply 145, then send surperficial 175A and the second energy to the first energy and send surperficial 175B and send electrosurgical energy.Can start energy by start button 124 and send, described start button operatively engages with trigger 128 and via cable 152 and controller 150 electric connections.The electrosurgical energy of being sent by power supply 145 as described above, can comprise the energy of radio frequency (RF) energy or other suitable form.In addition, in certain embodiments, the first relative energy sends surperficial 175A and the second energy is sent at least one carried of variable resistance positive temperature coefficient (PTC) main body in surperficial 175B.In one embodiment, the first energy is sent surperficial 175A and is comprised that passive electrode and the second energy send surperficial 175B and comprise active electrode.Send surperficial additional detail about electrosurgery end effector, jaw close mechanism and electrosurgical energy and describe to some extent in following United States Patent (USP) and disclosed patent application, all these patents and patent application are all incorporated herein by reference and form the part of this description in full: United States Patent (USP) 7.381.209; 7,311,709; 7,220,951; 7,189,233; 7,186,253; 7,125,409; 7,112,201; 7,087,054; 7,083,619; 7,070,597; 7,041,102; 7,011,657; 6,929,644; 6,926,716; 6,913,579; 6,905,497; 6,802,843; 6,770,072; 6,656,177; 6,533,784; And 6.500.176; And U.S. Patent Application Publication 2010/0036370 and 2009/0076506.

For some electro-surgical devices, may be difficult to obtain effective ligation in single vascular and large pluse tube bank.A kind of inefficacy of usually observing is broken for inward flange and the outward flange of tissue along sealing.Anisobaric between the blood vessel wall that tissue disruption is attributable to be furthered contracts.In addition, due to the electric current of high concentration, the tissue that the interior side direction of one or more active electrode contact areas is close to this zone is fused into coagulated material.When jaw furthers blood vessel wall, complete " uninfluenced " tissue resists pressure while amorphous coagulation thing and breaks.In addition, the hot activity that do not wait of heavily stressed concentration, active electrode and the upper jaw of the inside edge of the heavily stressed concentration of jaw outer edge, cutter slit and the outer wall on lower jaw and the location between the inwall contact surface also can cause tissue disruption.

The another kind of inefficacy of usually observing comprises that the radio-frequency (RF) energy circulation that has been organized in the cutter slit still keeps uninfluenced afterwards.This type of inefficacy can cause being difficult to cut and organize to obtain suitable crosscut and can adversely affect sealing integrity.In addition, in some cases, the tissue that directly contacts the location on active electrode surface can by mistake carbonization of part.Local heat can cause limited concretion formation and the follow-up dehydration of larger sealed volume.In this local heat zone be organized in electric current and therefore temperature distribution become too quickly dehydration before to the remainder of sealed volume.

When clamping and manipulating tissue, end effector can comprise tusk with anti-skidding and extrude.Toothed shape and pattern can be designed to make the infringement to tissue to minimize.When by tusk when for example the RF bipolar devices is combined, they need to cooperate to contribute to tissue to seal and clamp tissue with electrical property and the compression performance of device.Therefore, need noinvasive not only and also with the tusk suitably worked together with the energy type sealing of RF sealing or other type.Fig. 6 is the cutaway view with the toothed end effector 210 in the close position of noinvasive according to a non-limiting example.Be similar to the end effector 110 shown in Fig. 3-5, end effector 210 comprises the first jaw 220A and the second jaw 220B.Each can be defined for respectively passage 242A and the 242B that holds closed beam (not shown) the first jaw 220A and the second jaw 220B.Can limit cutter slit 272 to hold the cutting element (not shown) during operational stroke.Inner passage 272(Fig. 6) limit cross-table 233(Figure 10 of end effector 210), described cross-table is the plane that cutting element passes during operational stroke.In Fig. 6, the view of section view end of cross-table 233 is schematically illustrated by horizontal edge 281.Should be appreciated that in certain embodiments, if the path of the cutting element in end effector 210 is crooked, cross-table can be crooked.At least one had tusk 243 in the first jaw 220A and the second jaw 220B, described tusk is oriented to contribute to clamping, manipulation, energy to send and/or compresses institute's capture tissue.In certain embodiments, the carrying of at least one in the first jaw 220A and the second jaw 220B variable resistance positive temperature coefficient (PTC) main body 275.When in the close position, in one embodiment, at least a portion of PTC main body 275 is usually relative with electrode 277.Electrode 277 can bridge on insulating body 279 to avoid electrode 277 and radio frequency source 145(Fig. 1) return path (for example current-carrying part of the second jaw 220B) between contact.

Fig. 7 is the amplification view that is illustrated in the first jaw 220A of the end effector 210 in Fig. 6.The first jaw 220A can limit cross-section regional 204 usually, and described cross-section zone is arranged on the centre of the first side direction part 202 and the second side direction part 206 and is parallel to the cross-table of end effector 210.The first side direction part 202 can carry the first tusk 243A and the second side direction part can be carried the second tusk 243B.Tusk 243 can form integral body or one with upper wall 265A and the 265B of the first jaw 220A, as shown in the figure.In other embodiments, tusk 243 can utilize suitable means for attachment to join to or in other words be connected to the first jaw 220A.Laterally disposed tusk (for example tusk 243A and 243B) can have roughly " V-arrangement " cross-sectional profiles jointly.For example, the first tusk 243A can have inclined-plane 245A and the second tusk 243B can have inclined-plane 245B.Inclined-plane 245A can comprise inner 245AA and outside 245AB.Inclined-plane 245A can be inclination, makes inner 245AA be oriented to than outside 245AB more close cross-section regional 204.Similarly, inclined-plane 245B can comprise inner 245BA and outside 245BB.Inclined-plane 245B can be inclination, makes inner 245BA be oriented to than outside 245BB more close cross-section regional 204.The first tusk 243A can have the first cross-section region surface 247A and the second tusk 243B can have the second cross-section region surface 247B relative with the first cross-section region surface 247A side direction.Although inclined-plane 245A and 245B are shown as plane, be to be understood that in certain embodiments, inclined-plane 245A and/or 245B can be combination crooked or plane and crooked assembly.

Fig. 7 A is the zoomed-in view according to the part of the first tusk 243A of a non-limiting example and the first jaw 220A.The first tusk 243A can comprise lower surface 249A, and described lower surface joins inclined-plane 245A to first cross-section region surface 247A to contribute to noinvasive to engage the tissue of being caught.Inclined-plane 245A has tiltangleθ.In one embodiment, tiltangleθ is about 42 degree.Tiltangleθ can be based on application and is different.In certain embodiments, organize the type of the tissue that the tiltangleθ on inclined-plane can be based on being caught by end effector 210 or size that can be based on end effector 210.In certain embodiments, tiltangleθ can for example approximately 10 the degree to approximately 80 the degree scopes in.

The zoomed-in view of the portions of proximal of the first jaw that the perspective view that Fig. 8 is end effector 210 and Fig. 8 A are end effector 210.As shown in Fig. 8 and 8A, end effector 210 can have a plurality of tusks 243, and each has described a plurality of tusks and serve as the inclined-plane 245 of organizing composition surface.Tusk 243 can be elongated in the vertical, and wherein front surface 251 is positioned on distally and rear surface 253 is positioned on nearside.Front surface 251 can be inclination, and making its longitudinal axis with respect to the first jaw 220A 215 is roughly to tilt.Rear surface 253 can be approximately perpendicular to the longitudinal axis 215 of the first jaw 220A.In certain embodiments, rear surface 253 can be inclined to identical or different angle with front surface 251.In general, the front surface 251 of inclination allows to organize and relatively easily moves in

jaw

220A and 220B, and closed once jaw, square back (for example, rear surface 253) contribute to organize locks in place.From front surface 251 to lower surface 249 and the transition portion of rear surface 253 be circular to reduce the wound to institute's capture tissue.

In certain embodiments, the relatively long side profile of tusk 243 provides tissue compression with the energy when RF(or other type) maximize sealing when organizing energy supply.For example, in one embodiment, each tusk 243 is along approximately 3 to approximately 5 times of the degree of depth that be can be tusk 243 by the longitudinal length of arrow 241 indicated directions (as by the length measurment of rear surface 253).In one embodiment, each tusk 243 is along be can be approximately 2 to approximately 7 times of the toothed degree of depth by the longitudinal length of arrow 241 indicated directions.In certain embodiments, the longitudinal length of the comparable tusk 243 of the longitudinal pitch between adjacent tusk little approximately 2 to approximately 3 times to increase toothed conduction property and compression property.In certain embodiments, the longitudinal length of at least one tusk 243 can be different from the longitudinal length of different tusks 243.In addition, although tusk 243 is shown as the assembly of the first jaw 220A, should be appreciated that tusk 243 may be arranged on the second jaw 220B upper or the first jaw 220A and the second jaw 220B.In certain embodiments, that tusk 243 is conduction and be for radio frequency source 145(Fig. 1) the part of return path, wherein said toothed relatively large surface area contributes to tissue that compression catches and energy is delivered to caught tissue with for sealing.

Fig. 9 is the amplification view that is illustrated in the second jaw 220B of the end effector 210 in Fig. 6.Electrode 277 can have by cross-section regional 204 the first side direction part 277A that separate and the second side direction part 277B.The first side direction part 277A and the second side direction part 277B can have roughly " V-arrangement " cross-sectional profiles jointly.The concrete profile of electrode 277 can be coordinated mutually with the profile of tusk 243.For example, electrode incline angle Φ can be substantially similar to inclined-plane 245A(Fig. 7 A) tiltangleθ.In general, V-arrangement electrode profile is for increasing the Exposure of the tissue with caught, thereby for example reduces the probability that makes to organize carbonization.

The zoomed-in view of the part that Fig. 9 A is Fig. 9.Electrode 277 comprises a plurality of different parts, for example four parts.What contiguous cross-table was located is inner vertical portion 260, and it is transitioned into sloping portion 262.The transition outside from sloping portion 262 produces horizontal component 264, and it is transitioned into outside vertical portion 266 subsequently.As shown in the figure, the transition between a plurality of parts of electrode 277 can be circular, in order to reduce the collateral damage to caught tissue.Should be appreciated that other embodiment can utilize the electrode 277 with varying cross-section profile.Under any circumstance, tusk 243(Fig. 7 A) can there is the favourable interactional cross-sectional profiles provided with electrode 277.For example, in make position, the inclined-plane 245A of the first tusk 243A can be roughly parallel to the sloping portion 262 of electrode.

Fig. 6 A is the first jaw in the close position and the second jaw 220A illustrated according to a non-limiting example, the interactional cutaway view between 220B.In the illustrated embodiment, the first jaw 220A comprises tusk 243A and 243B.Should be appreciated that in certain embodiments, the first jaw 220A can comprise or can not comprise that tusk and the second jaw 220B can comprise or can not comprise tusk.In addition, the first jaw 220A is shown as carrying variable resistance PTC main body 275.Should be appreciated that in certain embodiments, the comparable illustrated embodiment of PTC main body 275 is wider, narrower, thinner or thicker.As used herein, the active electrode contact length is measured as the girth of the electrode 277 of contact institute capture tissue when the cross sectional planes from perpendicular to cross-table is observed.In certain embodiments, the active electrode contact length can be in the scope of for example approximately 0.088 " to approximately 0.269 ".In certain embodiments, the active electrode contact length can be in the scope of for example approximately 0.050 " to approximately 0.400 ".As used herein, the passive electrode contact length is measured as the first jaw 220A and the second jaw 220B part of contact institute capture tissue when the cross sectional planes from perpendicular to cross-table is observed.In certain embodiments, the passive electrode contact length can be in the scope of for example approximately 0.113 " to approximately 0.804 ".In certain embodiments, the passive electrode contact length can be in the scope of for example approximately 0.080 " to approximately 1.000 ".As used herein, contact area is than the ratio between active electrode contact length and passive electrode contact length.In certain embodiments, contact area is than for example approximately 0.145 to about 2.382 scope.In certain embodiments, contact area is than for example approximately 0.080 to about 3.000 scope.

Still, referring to Fig. 6 A, the distance identified by distance " A " is the inner horizontal spacing between the active electrode 277 on cutter slit 272 and the second jaw 220B.In one embodiment, distance A is in the scope of for example approximately 0.0 " to approximately 0.044 ".In another embodiment, distance A is in the scope of for example approximately 0.0 " to approximately 0.060 ".Distance by distance " B " sign is the level interval between relative active electrode 277 contact areas.In one embodiment, apart from B in the scope of for example approximately 0.0 " to approximately 0.034 ".In another embodiment, apart from B in the scope of for example approximately 0.0 " to approximately 0.112 ".Distance by distance " C " sign is the cutter slit 272 that limits of the first jaw 220A and the inner horizontal spacing between the active electrode 277 on the second jaw 220B.In one embodiment, distance C is in the scope of for example approximately 0.0 " to approximately 0.044 ".In another embodiment, distance C is in the scope of for example approximately 0.0 " to approximately 0.060 ".Distance by distance " D " sign is active electrode on the second jaw 220B and the inner horizontal spacing between passive electrode.In one embodiment, distance B is in the scope of for example approximately 0.0 " to approximately 0.013 ".In another embodiment, distance B is in the scope of for example approximately 0.0 " to approximately 0.025 ".Distance by distance " E " sign is active electrode on the second jaw 220B and the inner horizontal spacing between the passive electrode on the first jaw 220A.In one embodiment, apart from E in the scope of for example approximately 0.0 " to approximately 0.012 ".In another embodiment, apart from E in the scope of for example approximately 0.0 " to approximately 0.025 ".Distance by distance " F " sign is active electrode on the second jaw 220B and the outside vertical spacing between passive electrode.In one embodiment, apart from F in the scope of for example approximately 0.0 " to approximately 0.023 ".In another embodiment, apart from F in the scope of for example approximately 0.0 " to approximately 0.035 ".Distance by distance " G " sign is active electrode on the second jaw 220B and the outside vertical spacing between the passive electrode on the first jaw 220A.In one embodiment, apart from G in the scope of for example approximately 0.0 " to approximately 0.028 ".In another embodiment, apart from G in the scope of for example approximately 0.0 " to approximately 0.040 ".Distance by distance " J " sign is the compression elimination spacing on the second jaw 220B.In one embodiment, apart from J, be for example approximately 0.002 ".In another embodiment, apart from J, be for example approximately 0.005 ".Distance by distance " K " sign is the vertical distance that active electrode 277 is exposed to cutter slit 272.In one embodiment, apart from K in the scope of for example approximately 0.006 " to approximately 0.058 ".In another embodiment, apart from K in the scope of for example approximately 0.005 " to approximately 0.060 ".Rectilineal interval between the lower limb/turning of top edge/turning that the distance identified by distance " L " is active electrode 277 and the outer wall of the first jaw 220A.In one embodiment, distance L is in the scope of for example approximately 0.008 " to approximately 0.031 ".In another embodiment, distance L is in the scope of for example approximately 0.005 " to approximately 0.040 ".Rectilineal interval between the top edge/turning of lower limb/turning that the distance identified by distance " M " is active electrode 277 and the outer wall of the second jaw 200B.In one embodiment, apart from M in the scope of for example approximately 0.005 " to approximately 0.037 ".In another embodiment, apart from M in the scope of for example approximately 0.002 " to approximately 0.045 ".Air line distance between the tissue contacting surface that the distance identified by distance " N " is the second jaw 220B and the surface of the first jaw 220A.In one embodiment, apart from N in the scope of for example approximately 0.0 " to approximately 0.031 ".In one embodiment, apart from N in the scope of for example approximately 0.0 " to approximately 0.045 ".Distance by distance " P " sign is the compression elimination spacing on the first jaw 220A.In one embodiment, distance P is for example approximately 0.002 ".In another embodiment, distance P is for example approximately 0.005 ".

In general, the V-arrangement cross-sectional profiles of electrode 277 provides a plurality of beneficial effects, for example for active electrode surface increase additional contact length, allow active electrode surface and cutter slit than close proximity, allow between sealing area than the better thermal communication between close proximity and sealing area and allow introducing that the noinvasive tusk of required compression and chuck(ing) capacity is provided.

Figure 10 is the profile perspective according to the end effector in conjunction with offset electrode 210 of a non-limiting example.The cross-table 233 illustrated is roughly parallel to the path that the cutting element (not shown) is advanced during operational stroke.As shown in the figure, cross-table 233 is crooked, to mate the curve of the first jaw 220A and the second jaw 220B.Should be appreciated that in the embodiment that for example has the friction clamp mouth, cross-table 233 will be also straight.

Figure 11 is the end effector 310 according to a non-limiting example.The zoomed-in view of the part that Figure 11 A is Figure 11.End effector 310 can have the structure of the end effector 110 be similar to shown in Fig. 1, makes it have the first jaw 320A and the second jaw 320B.At least one had tusk 343 in jaw 320A and 320B is to contribute to manipulation and grip tissue.In certain embodiments, tusk 343 can have the structure of the tusk 243 for example be similar to shown in Fig. 7.For example, when use comprises the bipolar RF device (being illustrated in the electrosurgical unit 100 in Fig. 1) of the end effector with sealing jaws, importantly when organizing between the jaw that is not present in end effector, two independent conductive paths are (for example, energy supply path and energy return path) do not contact, otherwise will cause short circuit.As shown in Figure 11 A, the second jaw 320B can comprise the first electric conductivity stop part 322.The first electric conductivity stop part 322 is by insulator 326 and current electrode 324 insulation, and described current electrode is communicated with the energy supply path.In one embodiment, the first electric conductivity stop part 322 can be positioned in the far-end of cutter slit 327.Figure 12 is the fragmentary, perspective view according to the first jaw 320A of the end effector 310 of a non-limiting example.The first jaw 320A for example can comprise variable resistance positive temperature coefficient (PTC) main body 375 with energy return path electric connection.The first jaw 320A also can comprise the second electric conductivity stop part 328.The first electric conductivity stop part 322 can have surface 330, and when end effector 310 is in the close position and do not have any organizing in the middle of jaw, described surface can contact the surface 332 of the second electric conductivity stop part 328.This interaction prevents from producing unwanted energy flow (for example, radio-frequency (RF) energy) when electrosurgical unit is used, because electrode 324 will be prevented from contacting any other parts of PTC main body 375 or energy return path.In addition, this interaction between the first electric conductivity stop part 322 and the second electric conductivity stop part 328 prevents from the brute force of possibility damaging is applied to PTC main body 375.As shown in Figure 11 A and 12, the first electric conductivity stop part 322 and the second electric conductivity stop part 328 can be made by identical material with the other parts of end effector 310, thereby are convenient to manufacture.

As shown in figure 11, the first electric conductivity stop part 322 can be positioned near the distal end of end effector 310.Although the electric conductivity stop part 322 be illustrated in Figure 11 is columniform, should be appreciated that and can use any suitable structure.In one embodiment, the interstice for sealing is not set in interaction between the first electric conductivity stop part 322 and the second electric conductivity stop part 328, but only prevents when not existing in the middle of

jaw

320A and 320B while organizing unwanted contact of generation between the current electrode of end effector 310 and refurn electrode.For example, the I ellbeam relevant to cutting element can be set the interstice for sealing, and electric conductivity stop part 322 is organized the gap between time formation current electrode 324 and PTC main body 375 for not existing between the jaw when at end effector.Under any circumstance, because the first electric conductivity stop part 322 and the second electric conductivity stop part 328 can be conduction, so they can be delivered to energy while being trapped in organizing between

jaw

320A and 320B the sealing of serving as return path and therefore can contribute to tissue.

Figure 13 A and 13B are the cross-sectional side view of far-end during two kinds of different operating states that is illustrated in the end effector 310 in Figure 11.In Figure 13 A, while advancing through end effector 310 towards distally when I ellbeam (not shown), by described I ellbeam, set the placement of the first jaw 302A with respect to the second jaw 302B.Under this state, except between electrode 324 and PTC main body 375, having interval, also between the first electric conductivity stop part 322 and the second electric conductivity stop part 328, there is interval.In other words, under standard operation state, the first electric conductivity stop part 322 can contact the second electric conductivity stop part 328.As a comparison, Figure 13 B shows the end effector in " excessively closed " state.Crossing closure state can be caused by many factors, for example, loose matable assembly, surpasses assembly or the gravity of tolerance.Under this crosses closure state, between the first electric conductivity stop part 322 and the second electric conductivity stop part 328, exist and contact.Under this state, still stop electrode 324 and PTC main body 375 to form physical contact.

Figure 14 is the end effector 410 had in conjunction with the electrode 477 of magnificent husband's pattern.As used herein, magnificent husband's pattern comprises waffle-like pattern and non-waffle-like pattern.As shown in the figure, by magnificent husband's combination of patterns to the second jaw 420B.Yet should be appreciated that can be by magnificent husband's combination of patterns to the first jaw 420A.In general, the magnificent husband's pattern on electrode 477 can increase the quantity at surface area and edge, thereby can increase the amount of the tissue of contact electrode 477 when capture tissue.Sharpened edge also can contribute to concentrate electric energy to improve the transmission efficiency of electrode 477.Figure 15 shows the tissue contacting surface 422 of the first jaw 420A.As shown in the figure, the reverse pattern of magnificent husband's pattern of the second jaw 420B can be attached to the first jaw 420A.Can for example by PTC main body 475, produce reverse magnificent husband's pattern.In certain embodiments, can form in the following way corresponding indenture by the convex surfaces on electrode: heat these two kinds of elements and be compressed to desired depth.

The magnificent husband's pattern that is attached to end effector 410 can be any suitable pattern, for example convex surfaces 479(Figure 14) grid.In certain embodiments, magnificent husband's pattern can comprise the convex surfaces of random placement, maybe can comprise the convex surfaces that is arranged in grid and be positioned at the combination of the convex surfaces of random position.China's husband pattern can cover basically whole electrode 477 or be less than whole electrode 477 basically.Convex surfaces can be any suitable shape, for example square (as shown in the figure), oval, circular or any other bounded shape.Corresponding indenture 481 can have similar shape with convex surfaces 479.In certain embodiments, convex surfaces 479 can be in conjunction with a plurality of different shapes.The connecting surface 483 of cross-over bumps surface 479 and base surface 485 can be the outward-dipping value (as shown in the figure) with the increase surface area or is approximately perpendicular to base surface 485.Convex surfaces 479 can roughly be evenly distributed on whole electrode 477 or can in the different piece of electrode 477, have higher or lower concentration.In certain embodiments, end effector 410 can comprise more than 5 convex surfaces 479.In certain embodiments, end effector 410 can comprise more than 20 convex surfaces 479.In certain embodiments, end effector 410 can comprise more than 10 convex surfaces 479.In certain embodiments, end effector 410 can comprise more than 100 convex surfaces 479.Can for example, by any suitable manufacturing technology (, milling or impression), produce magnificent husband's pattern.In addition, in certain embodiments, convex surfaces can be attached to PTC main body 475(or other refurn electrode) and indenture can be attached to active electrode 277.In certain embodiments, convex surfaces 479 can have approximately 0.020 degree of depth of " height and indenture can have approximately 0.020 ".

Figure 16 is the far-end according to the movable cutting element 540 of a non-limiting example.Movable cutting element 540 can comprise a plurality of elements that extend laterally, for example the first jaw closure pin 542 and the second jaw closure pin 544.Some embodiment of movable cutting element 540 can have jaw and open pin 546.Should be appreciated that pin can extend laterally from two sides of movable cutting element 540.Movable cutting element 540 can consist of a plurality of bands, for example the first supporting strap 548, the second supporting strap 550 and be arranged on the cutter band 552 between supporting strap 548 and 550.Cutter band 552 can have sharp keen distally cutting blade 554.Supporting

strap

548 and 550 can be movable cutting element 540 and rigidity is provided and protects sharp keen distally cutting blade 554 in order to avoid meet with cutter slit 530(Figure 17) wall, thereby avoid the unexpected wearing and tearing on distally cutting blade 554.

In certain embodiments, movable cutting element 540 can limit at least one otch 556 through at least one band.At least one otch 556 can improve the side direction pliability of movable cutting element 540.The first supporting strap 548 and the second supporting strap 550 also can limit for example distally otch 558, for example recess.Otch 558 can be about longitudinal axis 552 roughly symmetrical or can be asymmetric (as shown in the figure).During crosscut, otch 558 pairs of tissues in distally provide funnelling tissue is pressed to cutting blade 554De center.In addition, movable cutting element 540 can be electrically coupled to the part (for example, passive electrode) of energy source to serve as the energy return path.

The view that Figure 17 is the far-end of the end effector 510 of use together with movable cutting element 540.End effector has the first jaw 520A and the second jaw 520B.The first jaw 520A limits cutter slit 530, and wherein movable cutting element 540 translates across this cutter slit.The first jaw 520A also can determine closure pin track 532 in arbitrary side of cutter slit 530 upper limit.Closure pin stop part 534 is arranged at least one far-end of closure pin track 532, to stop the distal movement of the first jaw closure pin 542 during operational stroke.Should be appreciated that the second jaw 520B can comprise that similar closure pin track and closure pin stop part are to hold the second jaw closure pin 544.The comparable closure pin track 532 of cutter slit 530 obtains farther towards distal extension, because the first jaw closure pin 542 is compared sharp keen distally cutting blade 554 slightly near the side location with the second jaw closure pin 544.During the crosscut stroke, the first jaw closure pin 542 and the second jaw closure pin 544 bridge in the pin closed orbit with while closed ends executor 510 and compress tissue.When movable cutting element 540 advances towards distally, sharp keen distally cutting blade 554 transecting patient tissues.Movable cutting element 540 can advance towards distally, until at least one double pointed nail stop part in jaw closure pin 542 and 544 is for example sold stop part 534.In certain embodiments, the use of pin stop part 534 can provide Cutting Length repeatably and can stop sharp keen distally cutting blade 554 is caused damage by the far-end that stops sharp keen distally cutting blade 554 contact cutter slits 530.

When using I ellbeam for example organizationally during closed ends executor's jaw, there is high initial load.This high initial load partly comes I ellbeam or other enclosed member of closed jaw away from the pivot of the pivot of end effector and close end effector owing to tissue.Be organized in when compressed the effect of usually playing spring.The compression degree of tissue is higher, and the required power of compress tissue is just larger.Once fluid has been forced out tissue, organizing just becomes is difficult to compression even more.In general, compression load is higher, and the power of pulling the trigger the I ellbeam is just larger.Even the jaw shut height of less variation (little of the .001 inch) for example can change significantly from being organized into the compression load of I ellbeam.In addition, there is the less tentering for the comprising embodiment of single trigger of (for example, being less than about 40mm), trigger has to utilize the stroke (for example, the path in Fig. 2 129) of less to carry out a large amount of work.As described in more detail below, this paper provides system and method for example, to reduce the required power (, " percussion force ") of executable operations stroke.

The shape (for example, slope) in the path that can for example, advance during operational stroke by change enclosed member (I ellbeam) in one embodiment, is reduced in to organize and is held the total amount that advances afterwards the required power of cutting element towards distally.In various embodiments, the shape of ramp profile can be cam-shaped roughly to reduce the total tissue compression stress.Figure 18 shows the cutaway view according to the end effector in an open position 610 of a non-limiting example.Be similar at front described embodiment, end effector 610 can have can be during operational stroke towards the first jaw 620A of the second jaw 620B pivotable.A plurality of pins that are connected to movable cutting element (not shown) can engage to open and/or

closed jaw

620A and 620B with a plurality of slopes in end effector 610.

In one embodiment, in order to open jaw 620A and the 620B of end effector 610, during present dynasty nearside tractive proximal pin 646, (for example,, when operational stroke finishes) proximal pin 646 can engage and open slope 660.Open slope 660 and can have crooked rear 662, described crooked rear can make the first jaw 620A along by arrow 647 indicated directions pivotable rapidly when engaging with proximal pin 646.Should be appreciated that the shape of cross section of opening slope 660 will affect the relative velocity that

jaw

620A and 620B open.For example, comprise there is relatively gradual slope the end effector of opening slope will than have the end effector of more suddenly opening slope open ground more slow.As shown in the figure, the far-end that keeps relatively fixing and the first jaw 620A as the second jaw 620B is during away from the far-end pivotable of the second jaw 620A, and

jaw

620A and 620B can " open ".Yet in certain embodiments, the second jaw 620B also can comprise and open slope, described open that slope is similar to the first jaw 620A open slope 660.In other embodiments, only the second jaw 620B comprises and opens slope, described far-end that slope can make the second jaw 620B far-end pivotable away from the first jaw 620A of opening.

End effector 610 can comprise that the additional cams pressure channel to hold the first jaw closure pin 642 and the second jaw closure pin 644 during operational stroke.In one embodiment, the first jaw 620A has the first closure pin track 632 and the second jaw 620B has the second closure pin track 633.The second closure pin track 633 can be (as shown in the figure) of substantially linear, or can comprise a plurality of inclinations or sweep.In the illustrated embodiment, the first closure pin track 632 has a plurality of slope profile to affect the action of the first jaw 620A during operational stroke and to reduce percussion force.Figure 19 shows far-end by movable cutting element and advances and make the first jaw 620A be pivoted to the end effector after the second jaw 620B.In the proximal end of the first closure pin track 632, it is relatively precipitous closed slope 650.When the first jaw closure pin 642 during from the position shown in Figure 18 towards the distally translation, its engage closed slope 650 so that the first jaw 620A towards the second jaw 620B pivotable relatively rapidly.The first jaw closure pin 642 runs into the ridge 652 that is positioned at 650 places, top, closed slope subsequently.Ridge 652 can have the flat that is transitioned into ramp portion 654 downwards.In certain embodiments, the tissue contacting surface of the first jaw 620A can be inclination, to be reduced in the compression shock advanced before movable cutting element the tissue of the far-end of end effector 610.Figure 20 shows the first jaw closure pin 642 that joins ramp portion 654 to.Ramp portion 654 is transitioned into the flat 656 in the middle of the far-end that is positioned at ramp portion 654 and end effector 610.The relative altitude of flat 656 can be substantially similar to the relative altitude of the flat of ridge 652.In various embodiments, proximal pin 646 can be positioned on movable cutting element, makes it not contact the first closure pin track 632.The second jaw closure pin 644 can be advanced along the second closure pin track 633 during operational stroke.

For clarity sake, according to the profile of the first closure pin track 632 of a non-limiting example, be illustrated in Figure 21.The ridge 652 with complete closure flat is led on closed slope 650.The flat of ridge 652 leads to ramp portion 654 down.Ramp portion 654 down is usually in the situation that maximum load alleviates clossing pressure.Ramp portion 654 recede until complete closure flat 656 with for final compression.By thering are many slope tracks, can utilize preferably the mechanical advantage of shank and can reduce percussion force when shank produces low mechanical advantage.Less compression stress while also returning because of it in order to the power of returning to movable cutting element is reduced.Should be appreciated that the profile that can revise in various embodiments track.For example, can revise the slope length of ramp portion 654, maybe can revise flat 656 to there is slope, maybe can make other modification.In addition, the second closure pin track 633 can be modified to and have the structure that is similar to the first closure pin track 632.

In certain embodiments, the frictional force that various decorations layers, coating and/or lubricant can be used between the motion assembly by reducing end effector reduces triggering power.In certain embodiments, at least one in the first jaw closure pin 642 and the second jaw closure pin 644 is coated with antifriction material.The track that pin is therefrom advanced also can be coated with antifriction material.In certain embodiments, antifriction material can comprise for example boron aluminum manganese (BAM), TiAlN (AlTiN), titanium nitride, diamond-like-carbon (DLC), molybdenum bisuphide titanium or vanadium carbide (VC).The side of movable cutting element also can be coated with antifriction material for example titanium nitride (TiN) for example to contribute to reduce the friction against the jaw track.The operation that in addition, can reduce percussion force and improve surgical instruments with any proper lubrication material.Incomplete and the non-limiting list of proper lubrication agent comprises for example KRYTOX, sodium stearate, DOW360 and NUSIL.The surface smoothness that also can revise a plurality of assemblies of end effector 610 rubs to reduce.For example, can carry out electrobrightening and can utilize grinding agent to carry out the secondary mechanical polishing the interface between a plurality of assemblies of end effector.In certain embodiments, target is decided to be the approximately average surface roughness of 4 to 16 microinch of acquisition.

In certain embodiments, a plurality of assemblies can be by contributing to the certain material that reduces frictional force to make.As mentioned above, the frictional force of reduction conjugative component can reduce the percussion force of end effector.In one embodiment, can use metastable copper (spinodal bronze) to help reduce frictional force.In general, metastable copper-clad contains copper and mickel and can operate well in the application with high load capacity and low velocity.A plurality of parts of end effector 610 (for example selling 642,644 and 646) can consist of metastable copper.Metastable copper can be purchased from ANCHOR BRONZE(for example, NICOMET) and BRUSH-WELLMAN(for example, TOUGHMET).The parts that consist of metastable copper can be used in multiple surgical instruments, for example straight cuts device, stiching instrument, radio-frequency unit and Vltrasonic device.

In certain embodiments, be reduced in the power at trigger place by other technology and make higher sealing probalility of success become possibility.For example, (for example, 0.006 ") reduced the amount of the required power of compress tissue can be reduced to by the amount by compressed tissue the thickness of less.Figure 22 is the cutaway view according to the jaw 720 of a non-limiting example.Be similar at front described jaw, jaw 720 can be defined for the cavity 724 that holds compressing member (for example I ellbeam) and the cutter cavity 722 that therefrom can pass cutting element.Jaw 720 also has the tapered electrode 777 be positioned on insulator 779.Tapered electrode 777 has the interior zone 780 towards the inward flange location of tapered electrode 777.In one embodiment, when compressing fully, interior zone 780 be positioned in relative jaw (not shown) on passive electrode between have approximately 0.006 " gap.This narrow zone is the zone of being intended to have maximal seal strength.Along with outside motion, tapered electrode 777 is away from interior zone 780 convergents and increase gap.Along with the increase in gap, the amount of tissue compression can reduce.Cone angle beta can be any suitable angle, for example, for example approximately 1 to approximately 30 the degree scopes in.In one embodiment, cone angle beta be approximately 10 the degree.In one embodiment, perimeter 782 regional 780 dropping distance d internally.In one embodiment, apart from d, be approximately 0.007 ".In certain embodiments, can be in the scope of for example approximately 0.002 " to approximately 0.020 " apart from d.By using conical surface, the tissue load in jaw can reduce approximately 30% to about 50% scope.In certain embodiments, passive electrode can be by alternatively for taper, or active electrode and passive electrode all can be taper.In general, electrode is tapered and can effectively reduces the amount that tissue is compressed by jaw, wherein the tissue of contiguous cutting element receives maximum compression.In certain embodiments, can implement other electrode configuration changes to realize the tissue compression on the whole contact surface of electrode.In one embodiment, for example electrode is columniformly with the narrow line contact position along jaw length, to carry out compress tissue.All this type of concrete enforcement all is intended to be contained by the present invention.

In certain embodiments, the relative distance between the compression pin on movable cutting element can be during the different phase of operational stroke and is different.For example, pin can during the compression/cutting part of stroke comparatively near and at movable cutting element during from the far-end of end effector retraction and towards the near-end translation of end effector comparatively away from.Movable cutting element 840 with movable pin is illustrated in Figure 23 A and 23B.Although movable cutting element 840 is shown as the banded cutting element similar with the cutting element 540 shown in Figure 16, is to be understood that and can uses any suitable movable cutting element.Movable cutting element 840 has the first jaw closure pin 842, the second jaw closure pin 844 and proximal pin 846.At least one in the first jaw closure pin 842 and the second jaw closure pin 844 can bridge in slit or cam face to allow relative to each other motion of pin 842 and 844.As shown in the figure, the first jaw closure pin 842 can be positioned in slit 850.Slit 850 can be inclination with respect to the longitudinal axis 851 of movable cutting element 840.In one embodiment, slot angles α be approximately 5 the degree.In certain embodiments, slot angles α can for example approximately 2 the degree to approximately 30 the degree scopes in.The particular location of the first jaw closure pin 842 in slit 850 will depend on the action of movable cutting element 840.In Figure 23 A, for example the first jaw closure pin 842 is shown as in as upper/lower positions, described position corresponding to movable cutting element 840 just along for example, by arrow 852 indicated direction translations (, during cutting).In this position, the vertical spacing ordered about downwards between the first jaw closure pin 842 and the first jaw closure pin 842 and the second jaw closure pin 844 is apart from d ₁.Comparatively speaking, in Figure 23 B, the first jaw closure pin 842 is shown as in as upper/lower positions, described position corresponding to movable cutting element 840 just along for example, by arrow 854 indicated direction translations (, during bouncing back).In this position, the vertical spacing upwards ordered about between the first jaw closure pin 842 and the first jaw closure pin 842 and the second jaw closure pin 844 is increased to apart from d ₂, d wherein ₂D ₁.Should be appreciated that d ₂And d ₁Between difference depend at least in part slot angles α.In other words, slot angles α is larger, d ₂And d ₁Between difference just larger.Between jaw closure pin 842 and 844, additional spacer in opposite direction distance will increase compression clearance, will reduce thus the required power of compressibility that bounces back.

In certain embodiments, the additional structure in the band of movable cutting element (for example, slit, recess or otch) can be used for guaranteeing closure pin (downwards) and motion that (makes progress) forward backward during operational stroke.A plurality of bands can be timed with the positive movement based on movable cutting element and adverse movement and promote up or down slotted pin.According to the movable cutting element 940 with translation band of a non-limiting example, be illustrated in Figure 24.Central zone 952 has vertical slit 960.Two tyres 948 have the slit 950 of inclination separately.The slit 950 tilted be with respect to longitudinal axis 951 inclinations of movable cutting element 940.The first jaw closure pin 942 is placed between three bands.During the cutting stroke, promote tyre 948 with respect to central zone 952 towards distally and impel the first jaw closure pin 942 towards the near-end of the slit 950 tilted and the vertically bottom motion of slit 960.In this position, the first jaw closure pin 942 just is applied to the compression stress of relative high quantity on institute's capture tissue with the second jaw closure pin 944.Figure 25 shows the movable cutting element 940 between retraction/return period.When with respect to central zone 952 towards the nearside tractive in addition 948 the time, impel the first jaw closure pin 942 towards the far-end of the slit 950 tilted and the vertically top motion of slit 960, thereby increase the vertical spacing between the first jaw closure pin 942 and the second jaw closure pin 944.In this position, spacer pin 942 and 944 the distance can reduce the tissue compression amount and reduce to bounce back the required power of movable cutting element 940.

In certain embodiments, can promote central zone 952 and the relative translation of tyre 948 during the stages of operational stroke with pushing block.Figure 26 shows and is being connected to the cutaway view of the trigger shaft 920 of pushing block 922 with cutting the stroke manipulate.Trigger shaft 920 operatively is connected to the trigger (not shown) of surgical instruments, make trigger shaft 920 can be respectively along by arrow 902 and 904 indicated directions, optionally advanced and/retraction.Pushing block 922 has distal face 924 and proximal side 926.For example, during the cutting stroke (, when trigger shaft 920 edges are advanced by arrow 902 indicated directions), three bands of movable cutting element 940 align on distal face 924.During the perspective view of movable cutting element 940 during the cutting stroke is illustrated in Figure 27.In this position, the vertical spacing between the first jaw closure pin 942 and the second jaw closure pin 944 in minimum range to produce maximum tissue compression.Figure 28 shows for example, cutaway view (, when trigger shaft 920 edges are bounced back by arrow 904 indicated directions) during the retraction of movable cutting element 940 of trigger shaft 920.During bouncing back, three bands of movable cutting element 940 align on proximal side 926.The perspective view of movable cutting element 940 during bouncing back is illustrated in Figure 29.In this position, the vertical spacing between the first jaw closure pin 942 and the second jaw closure pin 944 in ultimate range so that the tissue compression reduced amount to be provided.

In certain embodiments, at least one in closure pin can be the assembly by two or more independent module compositions.Figure 30 is the decomposition diagram that comprises the movable cutting element 960 of closure pin assembly.The perspective view of the movable cutting element 960 that Figure 31 is the Figure 30 in assembled configuration.The cutaway view that Figure 31 A is movable cutting element 960.In the illustrated embodiment, the first closure pin 962 and the second closure pin 964 are assembly, and proximal pin 966 is integrated.The first closure pin 962 can comprise axle 968 and first ring 970 and the second ring 972.Axle 968 and first ring 970 and the second ring 972 can be made by any suitable material.In one embodiment, axle 968 is that 17-7PH rustless steel and first ring 970 and second for example encircle 972, for alloy, TOUGHMET.First ring 970 and the second ring 972 can for example be pressure fitted on axle 968.As shown in the figure, can assemble the second closure pin 964 according to the mode that is similar to the first closure pin 962.For example, the second closure pin can comprise axle 974 and first ring 976 and the second ring 978.Should be appreciated that during operational stroke, encircle a plurality of closure pin tracks of 970,972,976,978 contact associated end executors.

The size of axle 968,974 and ring 970,972,976,978 size that can be based on end effector and different.In one embodiment, for example, axle 968,974 has approximately 0.0400 " (tolerance is +/-0.0002 ") external diameter.In one embodiment, for example, encircle and 970,972,976,978 have approximately 0.0394 " (tolerance is +/-0.0003 ") internal diameter.In one embodiment, for example, encircle and 970,972,976,978 have approximately 0.070 " (tolerance is +/-0.0003 ") external diameter.In one embodiment, between the first closure pin 962 and the second closure pin 064 apart from d3(Figure 31 A) can be approximately 0.148 " (tolerance is about +/-0.001 ").

In general, according to an embodiment, encircle 970,972,976,978 and allow to have relatively large external diameter so that closure pin 962,968 is captured in the track of end effector.In addition, encircle 970,972,976,978 relatively large external diameter and can prevent closure pin 962,968 perk in orbit (can cause like this blocking).If track for example is out of shape because of height clamping load, encircles 970,972,976,978 relatively large external diameter and also can contribute to guarantee that closure pin 962,964 still engages with track.In addition, in certain embodiments, can be in the situation that without hammering process (but source of its Processing for removing fluctuation) preparation closure pin 962,964.

Friction problem when in certain embodiments, closure pin can be pulled the trigger to reduce in conjunction with bearing.Figure 32 is the exploded view that comprises the closure pin 980 of needle bearing.Figure 33 is the cutaway view of the closure pin 980 after assembling.In one embodiment, closure pin 980 comprises axle 982.Axle can have for example diameter of about 1mm.Closure pin 980 can comprise the stepped hoop 984 with first 985 and second portion 986.The external diameter of first 985 can be greater than the external diameter of second portion 986.Closure pin 980 also can comprise inner hoop 988.Inner hoop 988 and stepped hoop 984 can limit recess 989 when assembling.Should be appreciated that recess 989 holds relevant movable cutting element (not shown).Closure pin 980 also can comprise first group of needle bearing 990 and second group of needle bearing 991.In one embodiment, each needle roller of needle bearing 990,991 has approximately 0.010 " diameter.The first round 992 and second takes turns 993 and can hold respectively first group of needle bearing 990 and second group of needle bearing 991.First end hoop 994 and the second end hoop 995 can for example utilize the pressure fitted juncture to be attached to axle 982.

When the wheel 992 of closure pin 980, but 993 when being connected to the movable cutting element of end effector engagement end portion executor's track.When movable cutting element translates across end effector, take turns 992,993 and can pass through first group of needle bearing 990 with second group of needle bearing 991 and mutually countershaft 968 rotations.Therefore, can reduce the frictional force that may stand during operational stroke.

In certain embodiments, end effector can comprise a plurality of structures that jointly contribute to reduce percussion force and/or return force.Figure 34 is the zoomed-in view according to the end effector 1010 of a non-limiting example.The cutaway view of the part that Figure 35 is end effector 1010.As shown in Figure 30 and 31, movable cutting element 1040 has the first jaw closure pin 1042, described the first jaw closure pin by slanted slots 1050 with respect to the second jaw closure pin 1044 translations to change the interval between these two pins.In addition, the first jaw 1020A comprises for engaging many slope tracks of the first jaw closure pin 1042 and proximal pin 1046.As shown in the figure, the first jaw 1020A comprises and opens slope 1060, closed slope 1050, ridge 1052 and ramp portion 1054, and this is similar to the end effector 610 shown in Figure 19.

Can utilize any suitable technology to carry out the attached a plurality of pins relevant with movable cutting element.In one embodiment, can utilize the keyway technology that pin is fixed to the movable cutting element of multi-band formula.For this type of embodiment, can use step pin 1142 as shown in figure 36.Step pin 1142 has longitudinal axis 1130, and described step pin comprises longitudinally at least two parts with various outer diameter of axis 1130.In one embodiment, mid portion 1144 has the diameter that is less than first outside the 1146 and second outside 1152.Figure 37 A and 37B show the tyre 1148 and 1149 according to a non-limiting example.Each tyre 1148 and 1149 has slit 1150, and described slit has larger hole 1151 at one end.With respect to tyre 1149, the hole 1151 on tyre 1148 is positioned on the opposite end of slit 1150.Hole 1151 has width w1 and slit 1150 has width w2.Width w2 can be slightly larger than the external diameter of the one in first outside the 1146 and second outside 1152 of step pin 1142.Width w1 can be slightly larger than the external diameter of mid portion 1144 but be slightly less than the diameter of first outside the 1146 and second outside 1152.In order to assemble movable cutting element, two tyres 1148 and 1149 are positioned such that what hole 1151 was alignment.Figure 38 A shows two of accompanying central zone 1152 and is with 1148 and 1149, and wherein their hole 1151 is alignment.For attached step pin 1142, (as shown in Figure 38 B) inserted in hole 1151 that it is passed through to alignment and, along contrary direction traction belt 1148, what make slit 1150 is captured in appropriate location than narrow by step pin 1142.The perspective view of the top far-end that Figure 39 is the movable cutting element 1140 after attached the first jaw closure pin 1142.

Under some mode of operation, surgical instruments can be changed into overload.For example, if just sealing and cutting trunk or large tissue bundle, clamp jaw and towards distally, drive the required power of cutting element can make a plurality of assembly overloads of device.In one embodiment, for the overload of anti-locking apparatus, can use the shear pin of having a mind to fracture when power reaches load threshold value.Figure 40 shows the shear pin 1200 according to a non-limiting example.Shear pin 1200 can by any suitable material, for example aluminum (for example, aluminium alloy 2024) or steel be made or form.In one embodiment, shear pin 1200 can be cut off at two points during overload.The first shear groove 1202 is positioned in an end place of shear pin 1200 and the other end place that the second shear groove 1204 is positioned in shear pin 1200.Should be appreciated that and can use in certain embodiments the single shear groove that is positioned at any correct position place.The size of shear pin 1200 can be determined by application and operational threshold.In certain embodiments, shear pin 1200 can be in its power lower than the assembly that can damage the associated surgical apparatus of about 60lbf() under cut off.Shear pin can be assembled in trigger assembly, thereby allow the freely-movable of trigger after cutting off.Figure 41 is the simple version that comprises the trigger assembly 1210 of shear pin 1200.Trigger 1210 can be around pivot 1212 pivotables to apply linear movement on trigger shaft 1214.Trigger shaft 1214 can operatively be connected to the end effector (not shown) at its far-end.Trigger shaft 1214 limits the bore hole 1216 that holds shear pin 1200.Trigger 1210 is connected to support 1220, and described support operatively is connected to the shear groove 1202 of shear pin 1200.Power from trigger 1210 is delivered to the end effector (not shown) by shear pin 1200.Trigger 1210 can for example advance the cutter in end effector towards distally.During non-overload, along can be made trigger shaft 1214 for example, towards distally translation (, edge is by arrow 1224 indicated directions) by arrow 1222 indicated direction rotary contact hair devices 1210.Yet, during overload situations, the power that is delivered to shear groove 1202 by support 1220 will be cut off shear pin 1200 and trigger 1210 is separated with trigger shaft 1214 at shear groove 1202 places.

Figure 42 shows surgical instruments 1230, has wherein removed the part of shell so that a plurality of intrawares to be shown.Surgical instruments 1230 is in conjunction with the shear pin 1240(Figure 44 as the overload member).The zoomed-in view of the part that Figure 43 is trigger assembly 1232, wherein for clarity sake removed a plurality of assemblies.The exploded view of a plurality of assemblies that Figure 44 is trigger assembly 1232, wherein for clarity sake removed a plurality of assemblies.Referring to Figure 42-44, surgical instruments 1230 can be worked by the mode that is similar to above-described embodiment usually.For example, trigger 1234 along path 1236 the actuatable end effector (not shown) that moves.For example, end effector can have the therefrom jaw of translation cutter.Can carry out drive end executor's actuating by the gear assembly 1238 that operatively is connected to trigger 1234 and tooth bar 1240.As the operator, during along path 1236 motion trigger 1234, trigger assembly 1232 can be around pivotal pin 1240 pivotables.Trigger assembly can comprise the first side trigger plate 1242 and the second side trigger plate 1244, wherein at the two, is provided with centre trigger plate 1246.Centre trigger plate 1246 can be connected to trigger 1234.As described in more detail below, returning to pin 1248 can be connected to centre trigger plate 1246 and bridge and return to slit 1250 what limited by the first side trigger plate 1242.The second side trigger plate 1244 can limit following slit, and described slot type is similar to be returned to slit 1250 and can hold a part of returning to pin 1240.When actuating trigger 1234, actuation plate 1252 also can, around pivotal pin 1240 pivotables, make tooth bar 1254 engaging gear assemblies 1238 final actuation end executor.

As shown in figure 44, the first side trigger plate 1242 and the second side trigger plate 1244 can limit respectively the first shear pin bore hole 1260 and the second shear pin bore hole 1262 separately.Shear pin 1240 can be held by the first shear pin bore hole 1260 and the second shear pin bore hole 1262.When assembled, the middle body 1264 of shear pin 1240 can engage centre trigger plate 1246(Figure 43) bore hole.Shear pin 1240 can have first end 1266 and the second end 1268 that engages respectively the first side trigger plate 1242 and the second side trigger plate 1244.Shear pin 1240 can limit the first shear groove 1270 that is positioned in first end 1266 and middle body 12654 centres and be positioned in middle body 12654 and the second shear groove 1272 of first end 1266 centres.

Referring now to Figure 42-44,, in one embodiment, surgical instruments 1230 is used in end effector and advances cutter towards distally, and described end effector comprises the jaw (not shown) for grip tissue.When load becomes too high, the first side trigger plate 1242 and the second side trigger plate 1244 are applied to excessive power on the first end 1266 and the second end 1268 of shear pin 1240.Finally, the one or both place fracture of shear pin 1240 in shear groove 1270,1272.Once, after shear pin 1240 fracture, trigger 1234 is not with regard to because the first side trigger plate 1242 and the second side trigger plate 1244 and separating of centre trigger plate 1246 promoting forward cutter again.Yet, after shear pin 1240 fracture, return pin 1248 by its with return to engaging of slit 1250 and allow trigger 1234 tractive cutter backward.Therefore, in one embodiment, even trigger 1234 can not be again advanced cutter towards distally, but trigger 1234 still can be used for by returning to the cutter that bounces back that connects of pin 1248 and the first side trigger plate 1242 and the second side trigger plate 1244.Once, after the cutter retraction, just can open the jaw of end effector and remove tissue.Therefore, in one embodiment, after standing overload, trigger 1234 be prohibited to be pushed forward to cutter but still recoverable cutter so that end effector and institute capture tissue break away from.Although shear pin 1240 is to illustrate under the background of electrosurgical unit, it also can be used for the surgical instruments of other type, for example, for the straight cuts device of clamping, cut-out and suture tissue.

In certain embodiments, can be by other Standard to can be applied to the maximum of power of a plurality of assemblies of end effector in surgical device with restriction.In one embodiment, for example spring or a series of spring can serve as compressor and be applied to the maximum, force of end effector with restriction.But the maximum compression load capacity that the spring preload is required and only when applying overload power, just change (for example, compression).Spring can have axial character and can be any suitable type, for example the Hookean spring member of compression-type, Bei Shi (belleville) type, die springs or other type.During normal service load, compression element generally serves as solid element.Compression stress is sent to movable cutting element by the direct slave flipflop of for example trigger shaft.Yet, when applying overload power, compression element will compress to absorb excessive power and the restriction of transfer amount to the power of end effector.In one embodiment, make compression element compress the amount of the amount of required power lower than the power of the component failures that will cause end effector.

Figure 45 shows the compression element 1300 according to the driving shaft inside that is installed to surgical instruments of a non-limiting example.Trigger shaft 1302 will be sent to from the power of trigger (not shown) movable cutting element 1340.Compression element 1300 is shown as a series of Belleville washers, but can use any suitable compression element.The cutaway view that Figure 45 A is Figure 45.Plunger 1304 operatively engages with pushing block 1306.When applying overload power, trigger shaft 1302 will be because of the compression of compression element 1300 with respect to plunger 1304 translations.In certain embodiments, trigger shaft 1302 can be connected to pin 1308 and plunger 1304 operatively is connected to member 1310.Member 1310 can limit slit 1312 to hold pin 1308.During overload, selling 1308 can be when compression element 1300 compression and with respect to slit 1312 translations.Therefore, the longitudinal length of slit 1312 can limit the relative translation of trigger shaft 1302 relative plungers 1304.

The embodiment of device as herein described can utilize Wicresoft or open surgical procedures technology to introduce in patient body.In some cases, maybe advantageously with the combination of Wicresoft and open surgical procedures technology, will install and introduce in patient body.Less invasive techniques can be more accurately and is effectively touched the area for treatment for the diagnosis and treatment of process.In order to arrive the internal therapentics zone in patient body, device as herein described can insert the natural opening through health, for example mouth, anus and/or vagina.By by various medical treatment devices, the natural opening by the patient guides to the Minimally Invasive Surgery of implementing in patient body and is known in the industry as NOTES ^TMOperation.Some part of device can guide to the organized processing zone via skin or by little keyhole otch.

Endoscope type micro-wound surgical operation and diagnostic medical process are used for by assessing and treat the internal in the tubule insertosome.Endoscope can have rigidity or flexible pipe.Soft endoscope can for example, by nature health opening (mouth, anus and/or vagina) or be introduced by the keyhole otch (being generally 0.5-1.5cm) of less via the trocar.Endoscope can be used to observe internal's surface appearance, comprises abnormal or ill tissue, and for example pathological changes and other surface appearance, and catch image, with for vision-based detection and photography.Endoscope can be suitable for and can have active channel, for medical apparatus and instruments being guided to area for treatment, to carry out biopsy, check foreign body and/or to carry out surgical operation.

Preferably, before surgical operation, will the various embodiment of device as herein described be processed.At first, obtain newly or with the apparatus of crossing, and where necessary apparatus is cleaned.Then apparatus is carried out disinfection.In a kind of sterilization technology, by apparatus be placed in the sealing and the sealing container, for example plastics or

In pocket.Then container and apparatus are placed in to the radiation area that can penetrate this container, for example gamma-radiation, x-ray or high energy electron.Radiation by apparatus and container in antibacterial kill.Then the apparatus after sterilizing is kept in disinfecting container.The sealing container keeps aseptic by apparatus, until open this container in armarium.Other disinfection technology can be undertaken by any various ways well known by persons skilled in the art, comprises β radiation, gamma-radiation, oxirane and/or steam.

Although in conjunction with some disclosed embodiment, the various embodiments of device is described in literary composition, many modification and the modification of these embodiment also can be implemented.For example, can adopt dissimilar end effector.In addition, every situation disclosed for the material of some assembly, all can be used other material.Above-mentioned explanation and following claim are intended to contain all these class modification and modification.

With way of reference in full or any patent, announcement or other the open material that partly are incorporated to this paper all only at the material be incorporated to, with in existing definition of the present invention, statement or the afoul scope of other open material be not incorporated to this paper.Thus, under necessary degree, this paper the disclosure clearly set forth any material that conflicts mutually that replacement is incorporated herein by reference.If according to state be incorporated herein by reference but with existing definition as herein described, statement or the afoul any material of other open material or its part, only under the degree that does not produce conflict between be incorporated to material and existing open material, be incorporated to this paper.

Claims

1. one kind for providing the surgical instruments of energy to tissue, comprising:

Shank, described shank comprises:

Trigger; With

Electrical input;

The axle extended from described shank, wherein said axle comprises conductor, and wherein said trigger can optionally activate to electrically connect described electrical input and described conductor; With

Limit the end effector of longitudinal axis and cross-table, described end effector comprises:

The first jaw member;

The second jaw member, at least one in wherein said the first jaw member and described the second jaw member can be with respect to the motion of the another one in described the first jaw member and described the second jaw member, to clamp described the first jaw member and the middle tissue of described the second jaw member;

The electrode electrically connected with described conductor; With

Be connected to the one in described the first jaw member and the second jaw member and organize composition surface and second to organize composition surface along first of described longitudinal axis extension, wherein said first to organize composition surface and second to organize each in composition surface to have inside and outside, wherein said first organize composition surface and second organize composition surface with respect to described cross-table for tilting.

2. surgical instruments according to claim 1, wherein said electrode comprises:

There is first outer peripheral the first side direction part;

There is second outer peripheral the second side direction part;

Connect the lateral part of described the first side direction part and described the second side direction part, wherein said first organizes composition surface and second to organize composition surface to be positioned in the middle of described the first outward flange and described the second outward flange.

3. surgical instruments according to claim 2, the first side direction part of wherein said electrode and the second side direction of described electrode partly jointly limit the V-arrangement profile.

4. surgical instruments according to claim 1, comprise electric conductivity the first stop part on described the first jaw member and electric conductivity the second stop part on described the second jaw member, when described the first jaw member and described the second jaw member when in the close position described the first stop part relative with described the second stop part, when described the first electric conductivity stop part contacts described electric conductivity the second stop part, between described electrode and galvanic circle, to form gap.

5. one kind for providing the surgical instruments of energy to tissue, comprising:

Shank, described shank comprises:

Trigger; With

Electrical input;

Limit the end effector of longitudinal axis, described end effector comprises:

The first jaw member;

The second jaw member, at least one in wherein said the first jaw member and described the second jaw member can move with respect to the another one in described the first jaw member and described the second jaw member between open position and make position, to clamp described the first jaw member and the middle tissue of described the second jaw member in described make position the time;

Passive electrode with passive electrode tissue contacting surface; With

Active electrode with the first active electrode tissue contacting surface and second active electrode tissue contacting surface, described active electrode and described conductor electrically connect, described the first active electrode tissue contacting surface is roughly parallel to described passive electrode tissue contacting surface in described make position, and described the second active electrode tissue contacting surface is roughly to tilt with respect to described passive electrode tissue contacting surface in described make position.

6. surgical instruments according to claim 5, wherein said active electrode limits the V-arrangement cross-sectional profiles.

7. surgical instruments according to claim 5, wherein said the first jaw comprises having the tusk of organizing grasping surface, wherein, in described make position, the described grasping surface of organizing is arranged essentially parallel to described the second active electrode tissue contacting surface.

8. surgical instruments according to claim 5, wherein said active electrode comprises the first vertical assembly and the second vertical assembly, the wherein said first vertical assembly and the second vertical assembly are arranged essentially parallel to the cross-table of described end effector.

9. surgical instruments according to claim 5, wherein, when in described make position, the lateral boundaries of described active electrode tissue contacting surface laterally is offset from the lateral boundaries of described the first passive electrode tissue contacting surface.

10. one kind for providing the surgical instruments of energy to tissue, comprising:

Shank, described shank comprises:

Trigger; With

Electrical input;

Limit the end effector of longitudinal axis, described end effector comprises:

The first jaw member;

The first electrode connected with described conductor, described the first electrode comprises a plurality of convex surfaces; With

The tissue contacting surface relative with described the first electrode in described make position, described tissue contacting surface limits a plurality of indentures, and described indenture is oriented to hold during in described make position when described the first jaw member and the second jaw member described a plurality of convex surfaces.

11. surgical instruments according to claim 10, wherein said a plurality of convex surfaces and described a plurality of indenture are arranged to grid.

12. surgical instruments according to claim 10, wherein said electrode comprises at least two ten convex surfaces.

13. surgical instruments according to claim 10, the degree of depth of " height and described a plurality of indenture have approximately 0.020 " that wherein said a plurality of convex surfaces have approximately 0.020.

14. one kind for providing the surgical instruments of energy to tissue, comprising:

Trigger; With

Electrical input;

The axle extended from shank, wherein said axle comprises conductor, and wherein said trigger can optionally activate to electrically connect described electrical input and described conductor; With

Limit the end effector of longitudinal axis, described end effector comprises:

The first jaw member;

Described the first jaw member and the second jaw member limit passage;

The cutting element that comprises far-end, the size of wherein said cutting element and structure are configured to be assemblied at least in part in described passage, described cutting element can be along described passage at advanced position and advance translation between position fully, described cutting element comprises at least the first band, the second band and the 3rd band, and wherein said the second band is arranged in the middle of described the first band and the 3rd band and comprises sharp keen distal incision element; With

At least one compressing member extended from described cutting element, wherein said at least one compressing member engages the one in described the first jaw and the second jaw, to make described the first jaw and the second jaw when described cutting element moves to outside described advanced position with respect to described the first jaw member, from described open position, moves to described make position.

15. surgical instruments according to claim 14, described the first jaw comprises that the first track and described the second jaw comprise the second track, and wherein said at least one compressing member comprises along the first compressing member of described the first orbital motion and along the second compressing member of described the second orbital motion.

16. surgical instruments according to claim 15, wherein said the first track comprises that the first distally stop part is to engage described the first compressing member, and described the second track comprises that the second distally stop part is to engage described the second compressing member.

17. surgical instruments according to claim 15, wherein said passage extends fartherly than described the first track and the second track along distal direction.

18. surgical instruments according to claim 14, wherein said the first band and the 3rd band comprise the funnel shaped part that is close to described sharp keen distal incision element.

19. one kind for providing the surgical instruments of energy to tissue, comprising:

Shank;

Trigger;

Electrical input;

Limit the end effector of longitudinal axis, described end effector comprises:

The first jaw member, described the first jaw member comprises the cam compressive surfaces along described longitudinal axis;

Described the first jaw member and the second jaw member limit passage;

The cutting element that comprises far-end, the size of wherein said cutting element and structure are configured to be assemblied at least in part in described passage, described cutting element can be along described passage at advanced position and advance translation between position fully; With

Extend and contact at least one compressing member of described cam compressive surfaces from described cutting element, wherein said at least one compressing member engages described cam compressive surfaces, when described cutting element moves to outside described advanced position with respect to described the first jaw member and the second jaw member, to make described the first jaw and the second jaw move to described make position from described open position.

20. surgical instruments according to claim 19, at least one in wherein said at least one compressing member and described cam compressive surfaces comprises at least one in friction coat.

21. surgical instruments according to claim 19, wherein said friction coat is a kind of in boron aluminum manganese, TiAlN and titanium nitride, diamond-like-carbon, molybdenum bisuphide titanium and vanadium carbide.

22. surgical instruments according to claim 19, at least a portion of wherein said end effector consists of metastable copper (spinodal bronze).

23. surgical instruments according to claim 19, wherein said cutting element consists of in addition the first tyre, central zone and second, described central zone, at least one in wherein said the first tyre and described the second tyre can be with respect to described central zone translation.

24. surgical instruments according to claim 25, each in wherein said the first tyre, central zone and the second tyre jointly limits size and sets the hole that holds described at least one compressing member for.

25. surgical instruments according to claim 26, wherein said central zone limits vertical slit and described first in addition and the second recess limited in addition with respect to described vertical recess inclination, and wherein said vertical slit and described recess jointly limit size and set the hole that holds described at least one compressing member for.

26. surgical instruments according to claim 23, wherein when described cutting element from described advanced position move to described while advancing position fully described first in addition and second in addition with respect to described central zone towards the distally translation, and wherein when described cutting element from described while advancing position translation to described advanced position fully described the first tyre and the second tyre with respect to described central zone towards the nearside translation.

27. surgical instruments according to claim 19, wherein said at least one compressing member is the pin with longitudinal axis, and described pin has at least two various outer diameters along described longitudinal axis.

28. surgical instruments according to claim 27, wherein said pin has the first diameter and Second bobbin diameter, wherein said the first diameter is greater than described Second bobbin diameter, wherein said first limits the slit with the first width and second width in addition, and wherein said the first width is greater than described the first diameter and described the second width is greater than described Second bobbin diameter but is less than described the first diameter.

29. surgical instruments according to claim 27, wherein said at least one compressing member is the assembly that comprises axle, first ring and the second ring.

30. surgical instruments according to claim 27, wherein said at least one compressing member comprises roller bearing.

31. one kind for providing the surgical instruments of energy to tissue, comprising:

Shank;

Trigger;

Electrical input;

Limit the end effector of longitudinal axis, described end effector comprises:

Described the first jaw member and the second jaw member limit passage;

The cutting element that comprises far-end, the size of wherein said cutting element and structure are configured to be assemblied at least in part in described passage, described cutting element can be along described passage at advanced position and advance translation between position fully, described cutting element limits cross-table; With

Electrode, described electrode comprises the taper tissue contacting surface.

32. surgical instruments according to claim 31, the cone angle of wherein said taper tissue contacting surface be approximately 10 the degree.

33. surgical instruments according to claim 31, wherein said tapered electrode comprises inside and outside, and the vertical distance between the surface of wherein said inner contiguous described passage and described inside and the surface of described outside is in the scope of approximately 0.002 " extremely approximately 0.020 ".

34. one kind for providing the surgical instruments of energy to tissue, described surgical instruments comprises:

Shank, described shank comprises:

Trigger;

Operatively be connected to the overload member of described trigger; With

Electrical input;

Limit the end effector of longitudinal axis, described end effector comprises:

The first jaw member;

The second jaw member, at least one in wherein said the first jaw member and described the second jaw member can move to clamp described the first jaw member and the middle tissue of described the second jaw member with respect to the another one in described the first jaw member and described the second jaw member; With

The electrode electrically connected with described conductor.

35. surgical instruments according to claim 34, wherein said overload member is the shear pin that comprises at least one shear groove.

36. surgical instruments according to claim 35, wherein said shear pin comprises aluminum.

37. surgical instruments according to claim 34, wherein said overload member comprises the one in disk spring, die springs and Hookean spring.

38., according to the described surgical instruments of claim 37, wherein said overload member comprises a plurality of disk springs.

39. one kind for providing the surgical instruments of energy to tissue, described surgical instruments comprises:

Shank;

Trigger;

Electrical input;

Limit the end effector of longitudinal axis, described end effector comprises:

Described the first jaw member and the second jaw member limit passage;

The cutting element that comprises far-end, the size of wherein said cutting element and structure are configured to be assemblied at least in part in described passage, described cutting element can be along described passage at advanced position and advance translation between position fully; And

Described cutting element comprises the first compressing member and the second compressing member be spaced a distance, described the first compressing member can join described the first jaw member to and described the second compressing member can join described the second jaw member to, and wherein said the first compressing member can be with respect to described cutting element motion.

40., according to the described surgical instruments of claim 39, the distance between wherein said the first compressing member and the second compressing member is variable range.

41. according to the described surgical instruments of claim 40, wherein when described cutting element, from described advanced position, move to described while advancing position fully the described variable range between described the first compressing member and the second compressing member be the first distance, wherein when described cutting element from described while advancing position translation to described advanced position fully the distance described the first compressing member and the second compressing member be second distance, and wherein said second distance is greater than described the first distance.