CN103429182B

CN103429182B - There is the surgical instruments of jaw member

Info

Publication number: CN103429182B
Application number: CN201180057867.5A
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: 2016-01-20
Anticipated expiration: 2031-09-27
Also published as: RU2013120005A; AU2011307338A1; CA2813389C; AU2011307338A8; CA2813389A1; JP2013541988A; WO2012044606A2; WO2012044606A3; JP5905472B2; AU2011307338B2; AU2011307338B8; EP2621390A2; RU2581715C2; CN103429182A; BR112013007879A2

Abstract

The invention discloses a kind of for providing the surgical instruments of energy to tissue, the axle that described surgical instruments can comprise shank, trigger, electrical input and extend from shank.Described surgical instruments can comprise end effector, and described end performs the first tissue engagement surface and minor microstructure composition surface that have and tilt relative to cross-table.Described end effector such as can have the electrode limiting V-arrangement cross-sectional profiles.Described end effector can be included in the multiple convex surfaces held by multiple indenture when described end effector is in described make position.Described end effector can comprise the cutting element with multiple band.A kind of axle for providing the surgical instruments of energy can comprise shank, trigger, electrical input and extend from shank to tissue.Described surgical instruments can comprise end effector.Described end effector can comprise cam compressive surfaces.Described end effector can comprise the electrode with tapered tissue contact surface.Some surgical instrumenties can comprise overload component.

Description

There is the surgical instruments of jaw member

Background technology

In all cases, surgical instruments can apply energy to process and/or to destroy this tissue to tissue.In some cases, surgical instruments can comprise one or more electrode, and described electrode against tissue positioned and/or relative to tissue positioned, can 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 conductor, this returns conductor and can such as allow electric current to flow through power supply conductor from electrical input, flow through electrode and tissue, then flow through and return 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 such as seal blood vessels.Described surgical instruments also can comprise cutting element, described cutting element can relative to tissue and electrode movement so that transecting patient tissue.

The various aspects of above-mentioned discussion just to illustrating that in technical field of the present invention, correlation technique is current, and should not be considered as the negative to right.

Summary of the invention

According to various embodiment, shank can be comprised for providing the surgical instruments of energy to tissue.The axle that shank can comprise trigger, electrical input and extend 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 limiting longitudinal axis and cross-table.End effector can comprise the first jaw member and the second jaw member.At least one in first jaw member and the second jaw member can relative to the another one motion in the first jaw member and the second jaw member, to clamp the tissue in the middle of the first jaw member and the second jaw member.End effector also can comprise the electrode and the first tissue engagement surface and minor microstructure composition surface that electrically connect with conductor, and described first tissue engagement surface and minor microstructure composition surface are connected to one in the first jaw member and the second jaw member and longitudinally Axis Extension.Each in first tissue engagement surface and minor microstructure composition surface all can have inside and outside, and wherein the first tissue engagement surface and minor microstructure composition surface are what tilt relative to cross-table.

According to various embodiment, shank can be comprised for providing the surgical instruments of energy to tissue.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 first jaw member and the second jaw member can be moved between the open position and the closed position relative to the another one in the first jaw member and the second jaw member, to clamp the tissue in the middle of the first jaw member and the second jaw member time in the close position.End effector can comprise the passive electrode with passive electrode tissue contacting surface and the active electrode with 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 passive electrode tissue contacting surface when in the closed position.When in the closed position, the second active electrode tissue contacting surface can be roughly to tilt relative to passive electrode tissue contacting surface.

According to various embodiment, for providing the surgical instruments of energy to comprise shank 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 limiting longitudinal axis.End effector can comprise the first jaw member and the second jaw member.At least one in first jaw member and the second jaw member can be moved between the open position and the closed position relative to the another one in the first jaw member and the second jaw member, to clamp the tissue in the middle of the first jaw member and the second jaw member time in the close position.End effector also can comprise the first electrode connected with conductor.First electrode can comprise multiple convex surfaces.When in the closed position, tissue contacting surface can be relative with the first electrode, and wherein tissue contacting surface can limit multiple indenture.Indenture can be oriented to when the first jaw member and the second jaw member in the close position time hold multiple convex surfaces.

According to various embodiment, for the axle providing the surgical instruments of energy can comprise trigger, electrical input and extend from shank to tissue.Axle can comprise conductor, and trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments also can comprise the end effector limiting longitudinal axis.End effector can comprise the first jaw member and the second jaw member.At least one in first jaw member and the second jaw member can be moved between the open position and the closed position relative to the another one in the first jaw member and the second jaw member, to clamp the tissue in the middle of the first jaw member and the second jaw member time in the close position.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 at advanced position and can advance between position along passage translation completely.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 the one that wherein at least one compressing member engages in the first jaw and the second jaw moves to make position to make the first jaw and the second jaw when cutting element moves to outside advanced position relative to the first jaw member from open position.

According to various embodiment, for the axle providing the surgical instruments of energy can comprise shank, trigger, electrical input and extend from shank to tissue.Axle can comprise conductor, and trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise the end effector limiting longitudinal axis.End effector can comprise the first jaw member and the second jaw member, described first jaw member comprises the cam compressive surfaces of longitudinally axis, at least one wherein in the first jaw member and the second jaw member can be moved between the open position and the closed position relative to the another one in the first jaw member and the second jaw member, to clamp the tissue in the middle of the first jaw member and the second jaw member time in the close position.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 at advanced position and can advance between position along passage translation completely.End effector can comprise from cutting element extension and contact at least one compressing member of cam compressive surfaces, and at least one compressing member engagement cam compressive surfaces wherein said moves to make position to make the first jaw and the second jaw when cutting element moves to outside advanced position relative to the first jaw member and the second jaw member from open position.

According to various embodiment, shank, trigger and electrical input can be comprised for providing the surgical instruments of energy to tissue.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 limiting longitudinal axis.End effector can comprise the first jaw member and the second jaw member, and described first jaw member comprises the cam compressive surfaces of longitudinally axis.At least one in first jaw member and the second jaw member can be moved between the open position and the closed position relative to the another one in the first jaw member and the second jaw member, to clamp the tissue in the middle of the first jaw member and the second jaw member time in the close position.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 at advanced position and can advance along passage translation between position completely, and wherein cutting element limits cross-table.End effector also can comprise the electrode with tapered tissue contact surface.

According to various embodiment, for providing the surgical instruments of energy to comprise shank to tissue, described shank comprises trigger, is operatively connected to the overload component of trigger and electrical input.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 first jaw member and the second jaw member can relative to the another one motion in the first jaw member and the second jaw member, to clamp the tissue in the middle 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 axle providing the surgical instruments of energy can comprise shank, trigger, electrical input and extend from shank to tissue.Axle can comprise conductor, and trigger can optionally activate to electrically connect electrical input and conductor.Surgical instruments can comprise the end effector limiting longitudinal axis.End effector can comprise the first jaw member and the second jaw member, and described first jaw member comprises the cam compressive surfaces of longitudinally axis.At least one in first jaw member and the second jaw member can be moved between the open position and the closed position relative to the another one in the first jaw member and the second jaw member, to clamp the tissue in the middle of the first jaw member and the second jaw member time in the close position.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 at advanced position and can advance between position along passage translation completely.Cutting element can comprise the first compressing member and the second compressing member that are spaced a distance.First compressing member can be and can join the first jaw member to and the second compressing member can be and can join the second jaw member to, and wherein the first compressing member can move relative to cutting element.

Accompanying drawing explanation

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

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

Fig. 2 is the side view of the shank of the surgical instruments of Fig. 1, wherein removes the half of shank body to illustrate some assemblies in it.

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

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

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

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

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

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

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

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

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

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

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

Figure 10 is the profile perspective of the end effector in conjunction with offset electrode according to 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 the distal part of the second jaw of the end effector be illustrated in Figure 11.

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

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

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

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

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

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

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

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

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

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

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

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 is the sectional view being operatively connected to the trigger shaft of pushing block according to a non-limiting example.

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

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

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

Figure 31 A is the sectional view of the movable cutting element of Figure 31.

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

Figure 33 is the sectional view of the closure pin through assembling of Figure 32.

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

Figure 35 is the sectional view of a part for the end effector be illustrated in Figure 34.

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

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

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

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

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

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

Figure 42 shows the surgical instruments according to a non-limiting example, wherein removes the part of shell to illustrate multiple intraware.

Figure 43 is the zoomed-in view of a part for trigger assembly, has wherein for clarity sake removed multiple assembly.

Figure 44 is the exploded view of multiple assemblies of the trigger assembly of Figure 43, has wherein for clarity sake removed multiple assembly.

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

Figure 45 A is the sectional view of Figure 45.

In described multiple view, corresponding reference marks represents corresponding parts.The example illustrated herein shows various embodiment of the present invention in one form, this example should be interpreted as it is limit the scope of the invention by any way.

Detailed description of the invention

Various embodiment relates to equipment, system and method for the treatment of tissue.Show many specific details, thus obtain to described in description and the overall structure of the embodiment shown in accompanying drawing, function, manufacture and purposes thorough understanding.But, it will be understood to those of skill in the art that and can implement described embodiment when there is no such specific detail.In other example, do not describe in detail know operation, assembly and element, in order to avoid make the embodiment that describes in description smudgy.Those of ordinary skill in the art will be understood that, described herein and shown embodiment is non-limitative example, and therefore can recognize, ad hoc structure disclosed herein and function detail may be representational, and need not limit the scope of embodiment, the scope of embodiment is only defined by the following claims.

" various embodiment ", " some embodiments ", " embodiment " or " embodiment " that this description is quoted in the whole text etc., refer to that specific features, structure or the characteristic described in conjunction with described embodiment comprises at least one embodiment.Therefore, this description occurs in the whole text phrase " in various embodiments ", " 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, without limitation, the specific features, structure or the characteristic that illustrate or describe in conjunction with an embodiment can be combined with the feature of other embodiment one or more, structure or characteristic whole or in part.

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

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

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

United States Patent (USP) 7,354,440, name is called ELECTROSURGICALINSTRUMENTANDMETHODOFUSE;

United States Patent (USP) 7,311,709, name is called ELECTROSURGICALINSTRUMENTANDMETHODOFUSE;

United States Patent (USP) 7,309,849, name is called POLYMERCOMPOSITIONSEXHIBITINGAPTCPROPERTYANDMETHODSOFFAB RICATION;

United States Patent (USP) 7,220,951, name is called SURGICALSEALINGSURFACESANDMETHODSOFUSE;

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

United States Patent (USP) 7,186,253, name is called ELECTROSURGICALJAWSTRUCTUREFORCONTROLLEDENERGYDELIVERY;

United States Patent (USP) 7,169,146, name is called ELECTROSURGICALPROBEANDMETHODOFUSE;

United States Patent (USP) 7.125.409, name is called ELECTROSURGICALWORKINGENDFORCONTROLLEDENERGYDELIVERY; With

United States Patent (USP) 7,112,201, name is called ELECTROSURGICALINSTRUMENTANDMETHODOFUSE.

The various embodiments of these system and methods relate to formation heat " welding " or " fusion " in natural fabric block.The alternative terms of tissue " welding " and tissue " fusion " is used interchangeably in this article, to describe, destination organization block is heat-treated, thus produce the substantial uniform piece of tissue fused together, show stronger rupture strength immediately in the Ink vessel transfusing post processing of such as welding.The intensity of this type of welding especially can be used for (i) sealed-for-life blood vessel in blood vessel crosscut operation; (ii) in resection operation, organ edge is welded; (iii) welding wherein needs permanent other closed anatomical conduit; And in addition (iv) can be used for perform angiostomy, vessel sealing art or anatomical structure or its part are bonded together other operation.Tissue welding disclosed herein or fusion are different from " condensation ", " hemostasis " and are usually directed to reduce and block other similar descriptive term of the blood flow in thin vessels or blood vessel tissue.Such as, apply heat energy to any surface and all may cause condensation or hemostasis, but do not belong to the category of term used herein " welding ".This type of surface condensation can not produce the welding organizing any remarkable intensity providing process.

At molecular level, the phenomenon of real " welding " tissue may come from the degeneration of collagen and other protein molecular in the destination organization block caused by heat as disclosed herein, to form transient state liquid state or gel protein mixture.Selected energy density is provided in destination organization, hydrothermal decomposition crosslinked with intermolecular hydrogen bonding in the molecule in collagen and other oroteins can be made.Can be very short selected by the protein mixture of degeneration is remained on selected hydration levels (not dewatering) in interval.Destination organization block is kept to be in the mechanical compress state of selected very high degree, closer to each other to guarantee the denatured protein unwind, to carry out interweaving and tangling.When hot relaxation, with being cross-linked the generation with renaturation again, the protein mixture mixed makes protein tangle, thus produces uniform fusion block together.

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

In more detail, in various embodiments, referring now to Fig. 1, electrosurgical unit 100 is shown.Surgical instruments or electrosurgical unit 100 can comprise proximal handle portion 105, distal working or end effector 110 and to be arranged between both and shank 105 to be operatively connected at least partly conductor or the slender axles 108 of end effector 110.End effector 110 can comprise one group can open/closeable jaw, has jaw-top first jaw 120A and bottom second jaw 120B that is straight or that bend.Jaw 120A and 120B can be operatively linked together, and the first jaw 120A can be moved between the open position and the closed position relative to the second jaw 120B.First jaw 120A and the second jaw 120B can to comprise along their corresponding mid portions respectively to the elongated slot of outer setting or passage 142A and 142B(separately see Fig. 3).First jaw 120A and the second jaw 120B is connected to power supply 145 and controller 150 by the electrical lead in cable 152.Controller 150 can be used for starting power supply 145.In various embodiments, power supply 145 can comprise the electric energy of such as radio frequency source, ultrasound source, DC source and/or other suitable type any.

Forward Fig. 2 to now, it illustrates the side view of shank 105, wherein the first shank body 106A(is see Fig. 1) half be removed some assemblies in the second shank body 106B are shown.Shank 105 can comprise the lever arm or trigger 128 that extend from shank body 106A and/or 106B.Can, along path 129 tractive trigger 128, make trigger 128 relative to main body 106A and/or 106B motion.Trigger 128 is also operatively connected to the movable cutting element 140 be arranged in slender axles 108 by reciprocating part 146, described reciprocating part operatively joins the extension 127 of trigger 128 to.Therefore, the motion of trigger 128 opposite shank main body 106A and/or 106B can make cutting element 140 relative to jaw 120A and 120B(see Fig. 1) in one or both translation.In addition, as described in more detail below, cutting element 140 can with closed beam 170(see 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, such as spring 141, described bias unit also can be connected to the second shank body 106B and also therefore be biased cutting element 140 and/or closed beam 170(Fig. 3 with biased reciprocating part 146), thus jaw 120A and 120B is pressed to open position, as shown in Figure 1.In addition, see Fig. 1 and 2, locking component 131(is see Fig. 2) locking switch 130(can be passed through see Fig. 1) move between latched position and unlocked position, in this latched position, substantially prevent reciprocating part 146 from distally moving as shown in the figure, at this unlocked position, reciprocating part 146 can be allowed freely to move along distal direction towards slender axles 108.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, for actuating 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 running through extension, for carrying such as activating the actuator mechanism (such as cutting element 140 and/or closed beam 170) of jaw, and for carrying the electrical lead of electrical power delivery to the electrosurgery assembly of end effector 110.

End effector 110 can be suitable for catching, weld or sealing and transecting patient tissue.First jaw 120A and the second jaw 120B can close to catch or joining tissue around the longitudinal axis 125 limited by cutting element 140 thus.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, rotate complete 360 degree by such as rotating triple contact relative to shank 105, as indicated by arrow 117.First jaw 120A and the second jaw 120B can remain and can to open and/or closeable while rotation.In certain embodiments, hoop 119 can be handled by user or other rotating control assembly rotates to make end effector 110.

Fig. 3 and 4 shows the perspective view of end effector 110.Fig. 3 shows the end effector 110 that is in and opens configuration and Fig. 4 shows the end effector 110 being in closed configuration.As mentioned above, end effector 110 can comprise top first jaw 120A and bottom second jaw 120B.In addition, the first jaw 120A and the second jaw 120B can have the tissue grasp element on the inside being arranged on the first jaw 120A and the second jaw 120B separately, such as tusk 143.First jaw 120A can comprise such as top first jaw main body 161A, and top first energy that described top first jaw main body has top first exterior surface 162A and the first electrode sends surperficial 175A.Second jaw 120B can comprise such as bottom second jaw main body 161B, and bottom second energy that described bottom second jaw main body has bottom second exterior surface 162B and the second electrode sends surperficial 175B.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 sends the tissue contacting surface that surperficial 175A, 175B can be provided for contacting, grasping and/or handle tissue between the two.

See Fig. 3-5, at least one embodiment, the size of closed beam 170 and cutting element 140 and structure can be set to be assemblied in the first jaw 120A at least in part passage 142A in.As shown in Figure 5, cutting element 140 size and structure also can be set to be assemblied in the second jaw 120B at least in part passage 142B in.Under any circumstance, closed beam 170 and cutting element 140 can along passage 142A first, advanced position and second, advance translation between 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 in the close position (see such as Fig. 4).The trigger 128(of shank 105 is see Fig. 2) can be suitable for activating cutting element 140 and activate the closed beam 170 being also used as jaw close mechanism subsequently.Such as, when along path 129 proximally tractive trigger 128 time, distally can push cutting element 140 and/or closed beam 170 via reciprocating part 146, 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 move or translation relative to slender axles 108 and/or jaw 120A, 120B separately.In addition, at least one embodiment, cutting element 140 can be such as made up of 17-4 precipitation-hardening stainless steel.In one embodiment, cutting element 140 is 716 rustless steels at least partially.The distal part of cutting element 140 can comprise flanged " I " ellbeam, and it can slide in passage 142A and 142B in jaw 120A and 120B.In at least one embodiment, the distal part of closed beam 170 can comprise " C " ellbeam, and it can slide in one in passage 142A and 142B.As in Figure 3-5, closed beam be depicted as be positioned at the first jaw 120A passage 142A within and/or on.Closed beam 170 can slide such as to carry out open and close first jaw 120A relative to the second jaw 120B in passage 142A.The distal part of closed beam 170 also can limit cam face 174, for the exterior surface 162A such as engaging the first jaw 120A.Therefore, when closed beam 170 passes passage 142A from when such as primary importance (Fig. 3) is distally advanced to the second position (Fig. 4), the first jaw 120A can be forced into closed (Fig. 4).Also the upper wall 165 by the first jaw 120A guides closed beam 170, and as shown in Figure 5, described upper wall can encapsulate closed beam 170 at least in part.For clarity sake, from Fig. 3-4, upper wall 165 is eliminated.

In addition, in various embodiments, the size of cutting element 140 and structure can be set to assembling at least in part or slide in closed beam 170, such as, 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, a part for cutting element 140 can transversely be given prominence in the direction of the longitudinal axis 172 limited by closed beam 170 from closed beam 170.Flange 144A and 144B of cutting element 140 can limit interior cam surface, for the closed inner passage 171 of beam 170 of joint and the exterior surface 162B of the second jaw 120B.As described in more detail below, the open and close of jaw 120A and 120B can utilize cam mechanism and jaw 120A, the exterior surface 162A of 120B, high compression stress is applied to tissue by 162B, and cam mechanism can comprise reciprocating " C ellbeam " closed beam 170 and/or " I ellbeam " cutting element 140.

More particularly, still see Fig. 3-5, flange 144A and 144B of the far-end of cutting element 140 can jointly be suitable for engaging the closed inner passage 171 of beam 170 and the second exterior surface 162B of the second jaw 120B slidably respectively.The size of the passage 142B in the passage 142A in the first jaw 120A and the second jaw 120B and structure can be set to the motion adapting to closed beam 170 and/or cutting element 140, described cutting element can comprise organizes cutting element, such as sharp keen distal side edge and/or surface.Such as, 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 the closed configuration shown in Fig. 4 from the configuration of opening shown in Fig. 3.Closed beam 170 can along passage 142A first, advanced position and second, completely advance between position and move or translation.Advanced position can as shown in Figure 3, and wherein jaw 120A, 120B are in an open position and far-end 178 that is closed beam 170 is oriented to adjacent upper portions exterior surface 162A.Although not shown, when the far-end 178 closing beam 170 is advanced to the far-end 164 of passage 142A and jaw is in the close position, can be formed and advance position completely, see Fig. 4.Equally, cutting element 140(Fig. 5) can relative to the first jaw advanced position with advance position translation completely, jaw 120A in advanced position, 120B (Fig. 3) in an open position, the far-end 164 advancing cutting element in position to be advanced to such as passage 142A completely, wherein jaw (Fig. 4) in the close position.As mentioned above, when closed beam 170 advances through jaw 120A, 120B, cutting element 140 also can relative to the translation of closed beam 170.

In at least one embodiment, the distal part of closed beam 170 and cutting element 140 can be positioned in the inside of the one or both in jaw 120A and 120B of end effector 110 and/or distally that is neighbouring and/or slender axles 108.In addition, the make position shown in Fig. 4, the second energy that the first energy that top first jaw 120A and bottom second jaw 120B limits the first jaw 120A respectively sends surperficial 175A and the second jaw 120B sends gap between surperficial 175B or dimension D.Dimension D can equal such as about 0,0005 " to about 0,040 ", and can equal such as about 0 in certain embodiments, 001 " to about 0,010 ".In addition, the first energy is sent the edge that surperficial 175A and the second energy send 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.First energy is sent surperficial 175A and the second energy and is sent surperficial 175B and can be connected to power supply 145 and controller 150 separately equally.First energy send surperficial 175A and the second energy send surperficial 175B can contact tissue and to seal being suitable for or the electrosurgical energy of weld structure is delivered to the tissue of joint.The electric energy that controller 150 scalable is sent by power supply 145, then sends surperficial 175A and the second energy to the first energy and sends surperficial 175B and send electrosurgical energy.Start energy by start button 124 to send, described start button operatively engages with trigger 128 and via cable 152 and controller 150 electric connection.As described above, the electrosurgical energy of being sent by power supply 145 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 at least one of sending in surperficial 175B can carry variable resistance positive temperature coefficient (PTC) main body.In one embodiment, the first energy is sent surperficial 175A and is comprised passive electrode and the second energy is sent surperficial 175B and included source electrode.Described by the additional detail sending surface about electrosurgery end effector, jaw close mechanism and electrosurgical energy has in following United States Patent (USP) and disclosed patent application, all these patents and patent application are incorporated herein by reference all in full and form the part of this description: 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 on single vascular and large pluse tube bank.To be tissue break along the inward flange of sealing and outward flange in a kind of inefficacy usually observed.Tissue disruption is attributable to by the unequal shrink estimator between the blood vessel wall that furthers.In addition, due to the electric current of high concentration, the tissue that in one or more active electrode contact area, side direction is close to this region is fused into coagulated material.When jaw furthers blood vessel wall, complete " uninfluenced " tissue resistance pressure simultaneously amorphous coagulation thing breaks.In addition, the thermal activities such as or not the outer wall on the heavily stressed concentration of the heavily stressed concentration of jaw outer edge, the inside edge of cutter slit, active electrode and upper jaw and lower jaw and the region place between contact internal walls surface also can cause tissue disruption.

The another kind of inefficacy usually observed comprises being organized in after radio-frequency (RF) energy circulates in cutter slit and still keeps uninfluenced.This type of inefficacy can cause being difficult to cut and organize obtain suitable crosscut and adversely can affect sealing integrity.In addition, in some cases, the tissue directly contacting the region place of active electrode surface can local by mistake carbonization.Local heat can cause limited concretion formation and the follow-up dehydration of larger sealed volume.In this localized heating zones be organized in electric current and therefore temperature distribution to sealed volume remainder before to become dehydration too quickly.

When clamp and manipulating tissue time, end effector can comprise tusk in case sliding stop and extruding.Toothed shape and pattern can be designed to the infringement to tissue is minimized.When by tusk and such as RF bipolar devices in conjunction with time, their need to cooperate to contribute to tissue encapsulation and clamp tissue with the electrical property of device and compression performance.Therefore, need not only noinvasive and seal with RF or the energy type of other type seal together with the tusk that suitably works.Fig. 6 is the sectional 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.First jaw 220A and the second jaw 220B is each can be defined for passage 242A and 242B holding closed beam (not shown) respectively.Cutter slit 272 can be limited to hold 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 figure 6, the view of section view end of cross-table 233 is schematically shown by horizontal edge 281.Should be appreciated that in certain embodiments, if the path of the cutting element in end effector 210 is bending, then cross-table can be bending.At least one in first jaw 220A and the second jaw 220B can have tusk 243, and described tusk is oriented to contribute to clamping, handles, energy is sent and/or compresses institute's capture tissue.In certain embodiments, at least one carrying variable resistance positive temperature coefficient (PTC) main body 275 in the first jaw 220A and the second jaw 220B.When in the closed position, in one embodiment, PTC main body 275 is usually relative with electrode 277 at least partially.Electrode 277 can bridge on insulating body 279 to avoid electrode 277 and radio frequency source 145(Fig. 1) return path (such as the current-carrying part of the second jaw 220B) between contact.

Fig. 7 is the amplification view of the first jaw 220A of the end effector 210 be illustrated in Fig. 6.First jaw 220A can limit cross section 204 usually, and described cross section 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.First side direction part 202 can carry the first tusk 243A and the second side direction part can carry the second tusk 243B.Tusk 243 can form entirety or one with upper wall 265A and 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 (such as tusk 243A and 243B) can have roughly " V-arrangement " cross-sectional profiles jointly.Such as, 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, and inner 245AA is oriented to than outside 245AB closer to cross section 204.Similarly, inclined-plane 245B can comprise inner 245BA and outside 245BB.Inclined-plane 245B can be inclination, and inner 245BA is oriented to than outside 245BB closer to cross section 204.First tusk 243A can have the first cross section surface 247A and the second tusk 243B can have the second cross section surface 247B relative with the first surface, cross section 247A side direction.Although inclined-plane 245A and 245B is shown as plane, be to be understood that in certain embodiments, inclined-plane 245A and/or 245B can be bending or plane and crooked assembly combination.

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

Fig. 8 is the perspective view of end effector 210 and Fig. 8 A is the zoomed-in view of the portions of proximal of the first jaw of end effector 210.As shown in figures 8 and 8, end effector 210 can have multiple tusk 243, and described multiple tusk is each has the inclined-plane 245 serving as tissue engagement surface.Tusk 243 can be elongated in the vertical, and wherein front surface 251 is positioned on distally and rear surface 253 and is positioned on nearside.Front surface 251 can be inclination, makes it be what roughly tilt relative to the longitudinal axis 215 of the first jaw 220A.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 closes once jaw, and square back (such as, rear surface 253) then contributes to organizing locks in place.Be circular to reduce the wound to institute's capture tissue from front surface 251 to the transition portion of lower surface 249 and rear surface 253.

In certain embodiments, the relatively long side profile of tusk 243 provides tissue compression with the energy as RF(or other type) maximize sealing to organizing during energy supply.Such as, in one embodiment, each tusk 243 can be about 3 to about 5 times of the degree of depth (length measurment as by rear surface 253) of tusk 243 along the longitudinal length by arrow 241 indicated direction.In one embodiment, each tusk 243 can be about 2 to about 7 times of the toothed degree of depth along the longitudinal length by arrow 241 indicated direction.In certain embodiments, the longitudinal length of the comparable tusk of the longitudinal pitch between adjacent tusk 243 little about 2 to about 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 tusk 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 or on 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 for sealing.

Fig. 9 is the amplification view of the second jaw 220B of the end effector 210 be illustrated in Fig. 6.Electrode 277 can have the first side direction part 277A and the second side direction part 277B that are separated by cross section 204.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.Such as, 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 with caught tissue, thus such as reduction makes tissue charring probability.

Fig. 9 A is the zoomed-in view of a part of Fig. 9.Electrode 277 comprises multiple different part, such as four parts.What contiguous cross-table was located is inner vertical part 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 multiple parts of electrode 277 can be circular, 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) the favourable interactional cross-sectional profiles provided with electrode 277 can be provided.Such as, 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 illustrates the first jaw in the close position according to a non-limiting example and the second jaw 220A, the interactional sectional 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 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, active electrode contact length is measured as the girth of the electrode 277 of the contact institute capture tissue when observing from the cross sectional planes perpendicular to cross-table.In certain embodiments, active electrode contact length can in the scope of such as about 0.088 " to about 0.269 ".In certain embodiments, active electrode contact length can in the scope of such as about 0.050 " to about 0.400 ".As used herein, passive electrode contact length is measured as the first jaw 220A and the second jaw 220B part of the contact institute capture tissue when observing from the cross sectional planes perpendicular to cross-table.In certain embodiments, passive electrode contact length can in the scope of such as about 0.113 " to about 0.804 ".In certain embodiments, passive electrode contact length can in the scope of such as about 0.080 " to about 1.000 ".As used herein, contact area is than being the ratio between active electrode contact length and passive electrode contact length.In certain embodiments, contact area is than in the scope of such as about 0.145 to about 2.382.In certain embodiments, contact area is than in the scope of such as about 0.080 to about 3.000.

Still see Fig. 6 A, be the inner horizontal spacing between active electrode 277 on cutter slit 272 and the second jaw 220B by distance " A " distance that identifies.In one embodiment, distance A is in the scope of such as about 0.0 " to about 0.044 ".In another embodiment, distance A is in the scope of such as about 0.0 " to about 0.060 ".The distance identified by distance " B " is the level interval between relative active electrode 277 contact area.In one embodiment, distance B is in the scope of such as about 0.0 " to about 0.034 ".In another embodiment, distance B is in the scope of such as about 0.0 " to about 0.112 ".Inner horizontal spacing between active electrode 277 on the cutter slit 272 limited for the first jaw 220A by distance " C " distance that identifies and the second jaw 220B.In one embodiment, distance C is in the scope of such as about 0.0 " to about 0.044 ".In another embodiment, distance C is in the scope of such as about 0.0 " to about 0.060 ".Be active electrode on the second jaw 220B and the inner horizontal spacing between passive electrode by distance " D " distance that identifies.In one embodiment, distance D is in the scope of such as about 0.0 " to about 0.013 ".In another embodiment, distance D is in the scope of such as about 0.0 " to about 0.025 ".The distance identified by distance " E " is the active electrode on the second jaw 220B and the inner horizontal spacing between the passive electrode on the first jaw 220A.In one embodiment, distance E is in the scope of such as about 0.0 " to about 0.012 ".In another embodiment, distance E is in the scope of such as about 0.0 " to about 0.025 ".Be active electrode on the second jaw 220B and the outside vertical spacing between passive electrode by distance " F " distance that identifies.In one embodiment, distance F is in the scope of such as about 0.0 " to about 0.023 ".In another embodiment, distance F is in the scope of such as about 0.0 " to about 0.035 ".The distance identified by distance " G " is the active electrode on the second jaw 220B and the outside vertical spacing between the passive electrode on the first jaw 220A.In one embodiment, distance G is in the scope of such as about 0.0 " to about 0.028 ".In another embodiment, distance G is in the scope of such as about 0.0 " to about 0.040 ".The distance identified by distance " J " is that spacing is eliminated in the compression on the second jaw 220B.In one embodiment, distance J is such as about 0.002 ".In another embodiment, distance J is such as about 0.005 ".The distance identified by distance " K " is the vertical distance that active electrode 277 is exposed to cutter slit 272.In one embodiment, distance K is in the scope of such as about 0.006 " to about 0.058 ".In another embodiment, distance K is in the scope of such as about 0.005 " to about 0.060 ".The distance identified by distance " L " is the rectilineal interval between the lower limb/turning of the top edge/turning of active electrode 277 and the outer wall of the first jaw 220A.In one embodiment, distance L is in the scope of such as about 0.008 " to about 0.031 ".In another embodiment, distance L is in the scope of such as about 0.005 " to about 0.040 ".The distance identified by distance " M " is the rectilineal interval between the top edge/turning of the lower limb/turning of active electrode 277 and the outer wall of the second jaw 200B.In one embodiment, distance M is in the scope of such as about 0.005 " to about 0.037 ".In another embodiment, distance M is in the scope of such as about 0.002 " to about 0.045 ".The distance identified by distance " N " is the air line distance between the tissue contacting surface of the second jaw 220B and the surface of the first jaw 220A.In one embodiment, distance N is in the scope of such as about 0.0 " to about 0.031 ".In one embodiment, distance N is in the scope of such as about 0.0 " to about 0.045 ".The distance identified by distance " P " is that spacing is eliminated in the compression on the first jaw 220A.In one embodiment, distance P is such as about 0.002 ".In another embodiment, distance P is such as about 0.005 ".

In general, the V-arrangement cross-sectional profiles of electrode 277 provides multiple beneficial effect, such as active electrode surface increase supplementary contact length, allow active electrode surface and cutter slit compared with close proximity, allows between sealing area compared with the better thermal connectivity between close proximity and sealing area and allow to introduce provide needed for compress and the noinvasive tusk of chuck(ing) capacity.

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

Figure 11 is the end effector 310 according to a non-limiting example.Figure 11 A is the zoomed-in view of a part of Figure 11.End effector 310 can have the structure being similar to the end effector 110 shown in Fig. 1, makes it have the first jaw 320A and the second jaw 320B.At least one in jaw 320A and 320B can have tusk 343 to contribute to handling and grip tissue.In certain embodiments, tusk 343 can have the structure being such as similar to the tusk 243 shown in Fig. 7.When use comprises bipolar RF device (being such as illustrated in the electrosurgical unit 100 in Fig. 1) of the end effector with sealing jaws, importantly when organizing between the jaw not being present in end effector, two independent conductive paths are (such as, energy feed lines and energy return path) do not contact, otherwise will short circuit be caused.As shown in Figure 11 A, the second jaw 320B can comprise the first electric conductivity stop part 322.First electric conductivity stop part 322 is insulated by insulator 326 and current electrode 324, and described current electrode is communicated with energy feed lines.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 of the first jaw 320A of end effector 310 according to a non-limiting example.First jaw 320A can comprise such as with variable resistance positive temperature coefficient (PTC) main body 375 of energy return path electric connection.First jaw 320A also can comprise the second electric conductivity stop part 328.First electric conductivity stop part 322 can have surface 330, when end effector 310 is in the close position and when there is not any organizing in the middle of the jaw, and the surface 332 of described Surface accessible second electric conductivity stop part 328.This interaction prevents from producing unwanted energy flow (such as, radio-frequency (RF) energy) when electrosurgical unit uses, because electrode 324 will be prevented from any other parts contacting 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 the brute force of possibility damaging to be applied to PTC main body 375.As shown in Figure 11 A and 12, the first electric conductivity stop part 322 can be made up of identical material with the other parts of end effector 310 with the second electric conductivity stop part 328, thus is 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, for columniform, should be appreciated that and can use any suitable structure.In one embodiment, interaction between first electric conductivity stop part 322 and the second electric conductivity stop part 328 not sets the interstice for sealing, but only prevent when do not exist in the middle of jaw 320A and 320B organize time end effector 310 current electrode with produce unwanted contact between refurn electrode.Such as, the I ellbeam relevant to cutting element can set the interstice for sealing, and electric conductivity stop part 322 is for forming the gap between current electrode 324 and PTC main body 375 when not existing between the jaw of end effector and organizing.Under any circumstance, because the first electric conductivity stop part 322 and the second electric conductivity stop part 328 can be conduction, therefore they can serve as return path when being delivered to by energy and being trapped in organizing between jaw 320A and 320B and therefore can contribute to the sealing of tissue.

Figure 13 A and 13B is the cross-sectional side view of far-end during two kinds of different operating states of the end effector 310 be illustrated in Figure 11.In figure 13a, when I ellbeam (not shown) is distally advanced through end effector 310, set the placement of the first jaw 302A relative to the second jaw 302B by described I ellbeam.In this case, except there is interval between electrode 324 and PTC main body 375, 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 being in " excessively closed " state.Cross closure state to be caused by many factors, such as, loose matable assembly, the assembly exceeding tolerance or gravity.Under this crosses closure state, between the first electric conductivity stop part 322 with the second electric conductivity stop part 328, there is contact.In this case, electrode 324 and PTC main body 375 is still stoped to form physical contact.

Figure 14 is the end effector 410 of the electrode 477 had in conjunction with magnificent husband's pattern.As used herein, magnificent husband's pattern comprises waffle-like pattern and non-grid shape pattern.As shown in the figure, by magnificent husband's combination of patterns on the second jaw 420B.But should be appreciated that can 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, thus can increase the amount of the tissue of contact electrode 477 when capture tissue.Sharpened edge also can contribute to concentrated 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.Such as can produce reverse magnificent husband's pattern by PTC main body 475.In certain embodiments, the convex surfaces on electrode can be used to form corresponding indenture in the following way: heat these two kinds of elements and be compressed to desired depth.

The magnificent husband's pattern being attached to end effector 410 can be any suitable pattern, such as 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 combination of the convex surfaces being arranged in grid and the convex surfaces being positioned at random position.China's husband pattern can cover whole electrode 477 or be less than whole electrode 477 substantially substantially.Convex surfaces can be any suitable shape, such as square (as shown in the figure), other bounded shape oval, circular or any.Corresponding indenture 481 can have similar shape with convex surfaces 479.In certain embodiments, convex surfaces 479 can in conjunction with multiple different shape.Cross-over bumps surface 479 and the connecting surface 483 of base surface 485 can be outward-dipping to increase the value (as shown in the figure) of surface area or to be approximately perpendicular to base surface 485.Convex surfaces 479 roughly can be evenly distributed on whole electrode 477 or can have higher or lower concentration in the different piece of electrode 477.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.Magnificent husband's pattern is produced by any suitable manufacturing technology (such as, milling or impression).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 about 0.020 degree of depth of " height and indenture can have about 0.020 ".

Figure 16 is the far-end of the movable cutting element 540 according to a non-limiting example.Movable cutting element 540 can comprise multiple element extended laterally, such as the first jaw closure pin 542 and the second jaw closure pin 544.Some embodiments 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 be made up of multiple band, such as the first supporting strap 548, second supporting strap 550 and the knife-band 552 that is arranged between supporting strap 548 and 550.Knife-band 552 can have sharp keen distally cutting blade 554.Supporting strap 548 and 550 can be movable cutting element 540 and provides rigidity and protect sharp keen distally cutting blade 554 in order to avoid meet with cutter slit 530(Figure 17) wall, thus avoid the unexpected wearing and tearing on distally cutting blade 554.

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

Figure 17 is the view of the far-end of the end effector 510 used together with movable cutting element 540.End effector has the first jaw 520A and the second jaw 520B.First jaw 520A limits cutter slit 530, and wherein movable cutting element 540 is translated across this cutter slit.First jaw 520A also can determine closure pin track 532 in arbitrary side upper limit of cutter slit 530.Closure pin stop part 534 is arranged in the far-end of at least one 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 similar closure pin track and closure pin stop part to hold the second jaw closure pin 544.Cutter slit 530 comparable closure pin track 532 distally extends farther, because the first jaw closure pin 542 compares sharp keen distally cutting blade 554 slightly near location, side with the second jaw closure pin 544.During crosscut stroke, the first jaw closure pin 542 and the second jaw closure pin 544 bridge in pin closed orbit with while closed ends executor 510 and compress tissue.When movable cutting element 540 distally advances, sharp keen distally cutting blade 554 transecting patient tissue.Movable cutting element 540 can distally advance, until at least one double pointed nail stop part in jaw closure pin 542 and 544, such as, sells stop part 534.In certain embodiments, sell the use of stop part 534 and can provide repeatably Cutting Length and far-end by stoping sharp keen distally cutting blade 554 to contact cutter slit 530 stops and causes damage to sharp keen distally cutting blade 554.

When using the jaw of such as I ellbeam closed ends executor organizationally, there is high initial load.This high initial loaded portion ground comes I ellbeam or other enclosed member of closed jaw owing to the pivot of tissue away from end effector and the pivot near end effector.Be organized in by the effect usually playing spring during compression.The compression degree of tissue is higher, then the power needed for compress tissue is larger.Once fluid is forced out tissue, organize just become even more be difficult to compression.In general, compression load is higher, then the power pulling the trigger I ellbeam is larger.Even relatively little jaw shut height change (little of .001 inch) such as can change the compression load from being organized into I ellbeam significantly.In addition, for the embodiment comprising the single trigger with relatively little tentering (such as, being less than about 40mm), trigger has to utilize relatively little stroke (path 129 such as, in Fig. 2) to perform a large amount of work.As described in more detail below, there is provided herein system and method to reduce the power (such as, " percussion force ") needed for executable operations stroke.

In one embodiment, the shape (such as, slope) by changing the path that enclosed member (such as I ellbeam) is advanced during operational stroke is reduced in organize and is distally advanced the total amount of the power needed for cutting element after clamping.In various embodiments, the shape of ramp profile can be cam-shaped roughly to reduce total tissue compression stress.Figure 18 shows the sectional view of the end effector 610 in an open position according to a non-limiting example.Be similar in front described embodiment, end effector 610 can have can towards the first jaw 620A of the second jaw 620B pivotable during operational stroke.The multiple pins being connected to movable cutting element (not shown) can engage with the multiple slopes in end effector 610 to open and/or closed jaw 620A and 620B.

In one embodiment, in order to open jaw 620A and 620B of end effector 610, when proximally tractive proximal pin 646, (such as, at the end of operational stroke) proximal pin 646 can engage and open slope 660.Open slope 660 and can have bending rear 662, described bending rear can make the first jaw 620A edge by arrow 647 indicated direction pivotable rapidly when engaging with proximal pin 646.Should be appreciated that the relative velocity that the shape of cross section of opening slope 660 will affect jaw 620A and 620B and opens.Such as, comprise there is relatively gradual slope the end effector opening slope by openly more slower than having the end effector more suddenly opening slope.As shown in the figure, during the far-end pivotable that the far-end of the first jaw 620A is away from the second jaw 620A when the second jaw 620B maintenance is relatively fixing, jaw 620A and 620B can " open ".But in certain embodiments, the second jaw 620B also can comprise and opens slope, described in 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 in open slope the far-end of the second jaw 620B can be made away from the far-end pivotable of the first jaw 620A.

End effector 610 can comprise 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.Second closure pin track 633 can be (as shown in the figure) of substantially linear, or can comprise multiple inclination or sweep.In the illustrated embodiment, the first closure pin track 632 has multiple slope profile to affect the action of the first jaw 620A during operational stroke and to reduce percussion force.Figure 19 is shown and is advanced by the far-end of movable cutting element and make the first jaw 620A be pivoted to end effector after the second jaw 620B.On the closed slope 650 that the proximal end of the first closure pin track 632 is comparable steepness.When the first jaw closure pin 642 from the position shown in Figure 18 distally translation time, it engages closed slope 650 to make the first jaw 620A towards the second jaw 620B pivotable relatively rapidly.First jaw closure pin 642 runs into the ridge 652 being positioned at top place, closed slope 650 subsequently.Ridge 652 can have the flat being transitioned into ramp portion 654 downwards.In certain embodiments, the tissue contacting surface of the first jaw 620A can be inclination, be reduced in advance movable cutting element before compression shock to the tissue of the far-end of end effector 610.Figure 20 shows the first jaw closure pin 642 joining ramp portion 654 to.Ramp portion 654 is transitioned into the flat 656 of the far-end centre being 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.Second jaw closure pin 644 can be advanced along the second closure pin track 633 during operational stroke.

For clarity sake, be illustrated in Figure 21 according to the profile of the first closure pin track 632 of a non-limiting example.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 alleviates clossing pressure when maximum load usually.Ramp portion 654 tilts backwards until complete closure flat 656 is for final compression.By having many slope tracks, the mechanical advantage of shank can be utilized preferably and can percussion force be reduced when shank produces low mechanical advantage.Power in order to return movable cutting element is also reduced because of less compression stress when it returns.Should be appreciated that the profile can revising track in various embodiments.Such as, the slope length of ramp portion 654 can be revised, maybe can revise flat 656 to have slope, maybe can make other amendment.In addition, the second closure pin track 633 can be modified to the structure having and be similar to the first closure pin track 632.

In certain embodiments, various decorations layer, coating and/or lubricant can be used for by reduce end effector moving parts between frictional force reduce trigger force.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.Sell the track of therefrom advancing and also can be coated with antifriction material.In certain embodiments, antifriction material can comprise such as 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 such as titanium nitride (TiN) such as to contribute to reducing the friction against jaw track.In addition, any proper lubrication material can be used to reduce percussion force and to improve the operation of surgical instruments.The non-limiting list of incomplete sum of proper lubrication agent comprises such as KRYTOX, sodium stearate, DOW360 and NUSIL.Also the surface smoothness of multiple assemblies of end effector 610 can be revised to reduce friction.Such as, can electrobrightening be carried out to the interface between multiple assemblies of end effector and grinding agent can be utilized to carry out secondary mechanical polishing.In certain embodiments, target is decided to be the average surface roughness of acquisition about 4 to 16 microinch.

In certain embodiments, multiple assembly can be made up of the certain material contributing to reducing frictional force.As mentioned above, the frictional force reducing conjugative component can reduce the percussion force of end effector.In one embodiment, metastable copper (spinodalbronze) can be used 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.Multiple parts (such as pin 642,644 and 646) of end effector 610 can be made up of metastable copper.Metastable copper can purchased from ANCHORBRONZE(such as, NICOMET) and BRUSH-WELLMAN(is such as, TOUGHMET).The parts be made up of metastable copper can be used in multiple surgical instruments, such as straight cuts device, stiching instrument, radio-frequency unit and Vltrasonic device.

In certain embodiments, use other technology to be reduced in the power at trigger place and to make higher sealing probalility of success become possibility.Such as, by being reduced to relatively little thickness (such as, 0.006 " by by the amount of tissue compressed) reduce the amount of power needed for compress tissue.Figure 22 is the sectional view of the jaw 720 according to a non-limiting example.Be similar at front described jaw, jaw 720 can be defined for the cavity 724 holding compressing member (such as 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 of locating towards the inward flange of tapered electrode 777.In one embodiment, when compressing completely, between interior zone 780 and the passive electrode being positioned on opposed jaws (not shown), have about 0.006 " gap.This narrow zone is the region being intended to have maximal seal strength.Along with outside motion, tapered electrode 777 is away from interior zone 780 convergent and increase gap.Along with the increase in gap, the amount of tissue compression can reduce.Cone angle beta can be any suitable angle, such as, in the scope of such as about 1 to about 30 degree.In one embodiment, cone angle beta is about 10 degree.In one embodiment, perimeter 782 is from interior zone 780 dropping distance d.In one embodiment, distance d is about 0.007 ".In certain embodiments, distance d can in the scope of such as about 0.002 " to about 0.020 ".By using conical surface, the load of organizing in jaw can reduce the scope of about 30% to about 50%.In certain embodiments, passive electrode can by alternatively for taper, or active electrode and passive electrode all can be taper.In general, electrode is tapered can effectively reduce the amount that tissue is compressed by jaw, wherein the tissue of contiguous cutting element receives maximum compression.In certain embodiments, other electrode configuration can be implemented to realize the tissue compression change on the whole contact surface of electrode.In one embodiment, such as electrode is columniform to carry out compress tissue at the narrow linear contact lay place along jaw length.This type of concrete enforcement all to be all intended to contain by the present invention.

In certain embodiments, the relative distance between the compression pin on movable cutting element can be different during the different phase of operational stroke.Such as, pin can during the compression/cutting part of stroke comparatively near and movable cutting element from the far-end of end effector retraction and towards during the near-end translation of end effector relatively further from.The 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, second jaw closure pin 844 and proximal pin 846.At least one in first jaw closure pin 842 and the second jaw closure pin 844 can bridge in slit or cam face to allow pin 842 and 844 relative to each other to move.As shown in the figure, the first jaw closure pin 842 can be positioned in slit 850.Slit 850 can be inclination relative to the longitudinal axis 851 of movable cutting element 840.In one embodiment, slot angles α is about 5 degree.In certain embodiments, slot angles α can in the scope of such as about 2 degree to about 30 degree.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, such as the first jaw closure pin 842 is shown as and is in as upper/lower positions, and described position corresponds to movable cutting element 840 just along by arrow 852 indicated direction translation (such as, during cutting).In this position, order about the first jaw closure pin 842 downwards and vertical spacing between the first jaw closure pin 842 and the second jaw closure pin 844 is distance d ₁.Comparatively speaking, in Figure 23 B, the first jaw closure pin 842 is shown as and is in as upper/lower positions, and described position corresponds to movable cutting element 840 just along by arrow 854 indicated direction translation (such as, during bouncing back).In this position, upwards order about the first jaw closure pin 842 and vertical spacing between the first jaw closure pin 842 and the second jaw closure pin 844 is increased to distance d ₂, wherein d ₂>d ₁.Should be appreciated that d ₂and d ₁between difference depend on slot angles α at least in part.In other words, slot angles α is larger, then d ₂and d ₁between difference larger.Between jaw closure pin 842 and 844, additional spacer distance in opposite direction will increase compression clearance, will reduce the power bounced back needed for compressibility thus.

In certain embodiments, the additional structure (such as, slit, recess or otch) in the band of movable cutting element can be used for guaranteeing closure pin (downwards) and forward (upwards) motion backward during operational stroke.Multiple band can be timed to promote slotted pin up or down based on the positive movement of movable cutting element and adverse movement.The movable cutting element 940 with translation band according to a non-limiting example is 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 is tilt relative to the longitudinal axis 951 of movable cutting element 940.First jaw closure pin 942 is placed between three bands.During cutting stroke, distally promote tyre 948 relative to central zone 952 and impel the near-end of the first jaw closure pin 942 towards the slit 950 tilted and the bottom motion of vertical slit 960.In this position, the compression stress of relative high number is just applied on institute's capture tissue by the first jaw closure pin 942 and the second jaw closure pin 944.Figure 25 shows the movable cutting element 940 between retraction/return period.When relative to central zone 952 proximally tractive in addition 948 time, impel the first jaw closure pin 942 towards the far-end of slit 950 tilted and the top movements of vertical slit 960, thus increase the vertical spacing between the first jaw closure pin 942 and the second jaw closure pin 944.In this position, the distance of spacer pin 942 and 944 can reduce tissue compression amount and reduce the power of retraction needed for movable cutting element 940.

In certain embodiments, pushing block can be used to promote central zone 952 and the relative translation of tyre 948 during each stage of operational stroke.Figure 26 shows the sectional view being operatively connected to the trigger shaft 920 of pushing block 922 during cutting stroke.Trigger shaft 920 is operatively connected to the trigger (not shown) of surgical instruments, and trigger shaft 920 can optionally be advanced by arrow 902 and 904 indicated direction and/retraction on edge respectively.Pushing block 922 has distal face 924 and proximal side 926.During cutting stroke (such as, when trigger shaft 920 is along when being advanced by arrow 902 indicated direction), three bands of movable cutting element 940 align in distal face 924.The perspective view of movable cutting element 940 during 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 is in minimum range to produce maximum tissue compression.Figure 28 shows trigger shaft 920 sectional view of (such as, when trigger shaft 920 is along when being bounced back by arrow 904 indicated direction) during the retraction of movable cutting element 940.During bouncing back, three bands of movable cutting element 940 align in 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 is in ultimate range to provide the tissue compression amount of reduction.

In certain embodiments, at least one in closure pin can for the assembly be made up of two or more independent assembly.Figure 30 is the decomposition diagram of the movable cutting element 960 comprising closure pin assembly.Figure 31 is the perspective view of the movable cutting element 960 of the Figure 30 being in assembled configuration.Figure 31 A is the sectional view of 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.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 up of any suitable material.In one embodiment, axle 968 is 17-7PH rustless steel and first ring 970 and the second ring 972 are alloy, such as TOUGHMET.First ring 970 and the second ring 972 can such as be pressure fitted on axle 968.As shown in the figure, the second closure pin 964 can be assembled according to the mode being similar to the first closure pin 962.Such as, the second closure pin can comprise axle 974 and first ring 976 and the second ring 978.Should be appreciated that during operational stroke, ring 970,972, multiple closure pin tracks of 976,978 contact associated end executors.

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

In general, according to an embodiment, ring 970,972,976,978 allow to have relatively large external diameter with by closure pin 962, and 968 are captured in the track of end effector.In addition, ring 970,972, the relatively large external diameter of 976,978 can prevent closure pin 962, and 968 tilt (can cause like this blocking) in orbit.If track is such as out of shape, then ring 970,972,976 because of high clamp load, the relatively large external diameter of 978 also can contribute to guaranteeing closure pin 962, and 964 still engage with track.In addition, in certain embodiments, can when without hammering process (its can Processing for removing fluctuation source) prepare closure pin 962,964.

In certain embodiments, closure pin can in conjunction with bearing to reduce friction problem during percussion.Figure 32 is the exploded view of the closure pin 980 comprising needle bearing.Figure 33 is the sectional view of the closure pin 980 after assembling.In one embodiment, closure pin 980 comprises axle 982.Axle can have the diameter of such as about 1mm.Closure pin 980 can comprise the stepped hoop 984 with Part I 985 and Part II 986.The external diameter of Part I 985 can be greater than the external diameter of Part II 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, needle bearing 990, each needle roller of 991 has about 0.010 " diameter.The first round 992 and second takes turns 993 and can hold first group of needle bearing 990 and second group of needle bearing 991 respectively.First end hoop 994 and the second end hoop 995 can such as utilize pressure fitted juncture to be attached to axle 982.

When the wheel 992,993 of closure pin 980 can the track of engagement end portion executor when being connected to the movable cutting element of end effector.When movable cutting element is translated across end effector, wheel 992,993 mutually countershaft 968 to rotate by first group of needle bearing 990 and second group of needle bearing 991.Therefore, the frictional force that may stand during operational stroke can be reduced.

In certain embodiments, end effector can comprise the multiple structures jointly contributing to reducing percussion force and/or return force.Figure 34 is the zoomed-in view of the end effector 1010 according to a non-limiting example.Figure 35 is the sectional view of a part for end effector 1010.As shown in figs. 30 and 31, movable cutting element 1040 has the first jaw closure pin 1042, described first jaw closure pin by slanted slots 1050 relative to the second jaw closure pin 1044 translation with change these two pin between interval.In addition, the first jaw 1020A comprises the many slope tracks for engaging 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.

Any suitable technology can be utilized to carry out the relevant multiple pins of attached and movable cutting element.In one embodiment, keyway technology can be utilized pin to be fixed to the movable cutting element of multi-band formula.For this type of embodiment, step pin 1142 as shown in figure 36 can be used.Step pin 1142 has longitudinal axis 1130, and described step pin comprises at least two parts with various outer diameter of longitudinally axis 1130.In one embodiment, mid portion 1144 has the diameter being less than the first outside 1146 and second outside 1152.Figure 37 A and 37B shows 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.Relative 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 slightly larger than the external diameter of the one in first of step pin 1142 outside 1146 and the second outside 1152.Width w1 can be slightly less than the diameter of the first outside 1146 and second outside 1152 slightly larger than the external diameter of mid portion 1144.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 bands 1148 and 1149 accompanying central zone 1152, and wherein their hole 1151 is alignment.In order to attached step pin 1142, the hole 1151 being passed through to align is inserted (as shown in fig. 38b) and along contrary direction traction belt 1148, makes the comparatively narrow of slit 1150 that step pin 1142 is captured in appropriate location.Figure 39 is the perspective view of the top far-end of movable cutting element 1140 after attached first jaw closure pin 1142.

Under some mode of operation, surgical instruments can be changed into overload.Such as, if just sealing and cutting trunk or organizing bundle greatly, then clamping jaw and distally driving the power needed for cutting element can make multiple assembly overloads of device.In one embodiment, in order to the overload of anti-locking apparatus, then the shear pin ruptured intentionally when the power that can be used in reaches load threshold value.Figure 40 shows the shear pin 1200 according to a non-limiting example.Shear pin 1200 can be made by any suitable material such as aluminum (such as, aluminium alloy 2024) or steel or be formed.In one embodiment, shear pin 1200 can be cut off at two points during overload.First shear groove 1202 is positioned in one end place of shear pin 1200 and the second shear groove 1204 is positioned in the other end place of shear pin 1200.Should be appreciated that the single shear groove that can use in certain embodiments and be 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 about 60lbf(its lower than the power of assembly can damaging associated surgical instrumentation) under cut off.Shear pin can be assembled in trigger assembly, thus allow the freely-movable of trigger after cutting off.Figure 41 is the simple version of the trigger assembly 1210 comprising shear pin 1200.Trigger 1210 can around pivot 1212 pivotable to apply linear movement on trigger shaft 1214.Trigger shaft 1214 can operatively be connected to end effector (not shown) at its far-end.Trigger shaft 1214 limits the bore hole 1216 holding shear pin 1200.Trigger 1210 is connected to support 1220, and described support is operatively connected to the shear groove 1202 of shear pin 1200.Power from trigger 1210 is delivered to end effector (not shown) by shear pin 1200.Trigger 1210 such as distally can advance the cutter in end effector.During non-overloaded state, trigger shaft 1214 distally translation (such as, edge is by arrow 1224 indicated direction) can be made along being rotated trigger 1210 by arrow 1222 indicated direction.But during overload situations, the power being delivered to shear groove 1202 by support 1220 will be cut off shear pin 1200 at shear groove 1202 place and make trigger 1210 be separated with trigger shaft 1214.

Figure 42 shows surgical instruments 1230, wherein removes the part of shell to illustrate multiple intraware.Surgical instruments 1230 is combined as shear pin 1240(Figure 44 of overload component).Figure 43 is the zoomed-in view of a part for trigger assembly 1232, has wherein for clarity sake removed multiple assembly.Figure 44 is the exploded view of multiple assemblies of trigger assembly 1232, has wherein for clarity sake removed multiple assembly.See Figure 42-44, surgical instruments 1230 can work by the mode being similar to above-described embodiment usually.Such as, trigger 1234 is along the actuatable end effector (not shown) that moves in path 1236.Such as, end effector can have the jaw of therefrom translation cutter.Gear assembly 1238 by being operatively connected to trigger 1234 and tooth bar 1240 carrys out the actuating of drive end executor.When operator is along path 1236 motion trigger 1234, trigger assembly 1232 can around pivotal pin 1240 pivotable.Trigger assembly can comprise the first side trigger plate 1242 and the second side trigger plate 1244, wherein between both, is provided with centre trigger plate 1246.Centre trigger plate 1246 can be connected to trigger 1234.As described in more detail below, return pin 1248 can be connected to centre trigger plate 1246 and bridge returning in slit 1250 of being limited by the first side trigger plate 1242.Second side trigger plate 1244 can limit following slit, and described slot type is similar to and returns slit 1250 and can hold the part returning pin 1240.When actuating trigger 1234, actuation plate 1252 also around pivotal pin 1240 pivotable, can make tooth bar 1254 engaging gear assembly 1238 and final actuation end executor.

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

Referring now to Figure 42-44, in one embodiment, surgical instruments 1230 is used in end effector and distally advances cutter, and described end effector comprises the jaw (not shown) for grip tissue.When load becomes too high, on the first end 1266 that excessive power is applied to shear pin 1240 by the first side trigger plate 1242 and the second side trigger plate 1244 and the second end 1268.Finally, shear pin 1240 is in shear groove 1270, ruptures in the one or both place in 1272.Once after shear pin 1240 ruptures, trigger 1234 just can not driven forward cutter again because of the first side trigger plate 1242 and the second side trigger plate 1244 and being separated of centre trigger plate 1246.But, after shear pin 1240 ruptures, return pin 1248 and allow trigger 1234 tractive cutter backward by itself and the joint returning slit 1250.Therefore, in one embodiment, even if trigger 1234 distally can not advance cutter again, but trigger 1234 still can be used for by returning connecting and the cutter that bounces back of pin 1248 and the first side trigger plate 1242 and the second side trigger plate 1244.Once after cutter retraction, the jaw of end effector just can be opened and removes tissue.Therefore, in one embodiment, after standing overload, trigger 1234 is prohibited to be pushed forward to cutter but still recoverable cutter departs to make end effector and institute's capture tissue.Although shear pin 1240 illustrates under the background of electrosurgical unit, it also can be used for the surgical instruments of other type, such as, for clamping, cutting off and the straight cuts device of suture tissue.

In certain embodiments, the maximum of the power of multiple assemblies of end effector can will be applied in other Standard to surgical device with restriction.In one embodiment, such as spring or a series of spring can serve as compressor is applied to end effector maximum, force with restriction.Spring can preload required maximum compression load capacity and only just change when applying overload power (such as, compressing).Spring can have axial character and can be any suitable type, such as the Hookean spring component of compression-type, bayesian (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 such as trigger shaft.But, when applying overload power, compression element will compression with absorb excessive power and the restriction of transfer to the amount of the power of end effector.In one embodiment, the amount of amount lower than the power of the component failures by causing end effector of the power needed for compression element compression is made.

Figure 45 shows the compression element 1300 being installed to the driving shaft inside of surgical instruments according to a non-limiting example.Power from trigger (not shown) is sent to movable cutting element 1340 by trigger shaft 1302.Compression element 1300 is shown as a series of Belleville washer, but can use any suitable compression element.Figure 45 A is the sectional view of Figure 45.Plunger 1304 operatively engages with pushing block 1306.When apply overload power time, trigger shaft 1302 by the compression because of compression element 1300 relative to plunger 1304 translation.In certain embodiments, trigger shaft 1302 can be connected to pin 1308 and plunger 1304 is operatively connected to component 1310.Component 1310 can limit slit 1312 to hold pin 1308.During overload, pin 1308 can when compression element 1300 compresses relative to slit 1312 translation.Therefore, the longitudinal length of slit 1312 can limit the relative translation of the relative plunger 1304 of trigger shaft 1302.

The embodiment of device as herein described can utilize Wicresoft or open surgical procedures technology to introduce in patient body.In some cases, the combination of Wicresoft and open surgical procedures technology is maybe advantageously used to be introduced in patient body by device.Less invasive techniques more accurately and effectively can touch the area for treatment for the diagnosis and treatment of process.In order to arrive the internal therapentics region in patient body, device as herein described can be inserted through the natural opening of health, such as mouth, anus and/or vagina.NOTES is known in the industry as by various medical treatment device is guided to by the natural opening of patient the Minimally Invasive Surgery implemented in patient body ^tMoperation.Some part of device can guide to tissue treatment area via skin or by little keyhole otch.

Endoscope type micro-wound surgical operation and diagnostic medical process are used for by assessing in tubule insertosome and treat internal.Endoscope can have rigidity or flexible pipe.Soft endoscope is introduced by natural health opening (such as mouth, anus and/or vagina) or via the trocar by relatively little keyhole otch (being generally 0.5-1.5cm).Endoscope can be used to the surface appearance of observing internal, comprises abnormal or ill tissue, such as pathological changes and other surface appearance, and catches image, 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 perform surgical operation.

Preferably, processed to the various embodiments of device as herein described before surgical operation.First, obtain new or with the apparatus crossed, and where necessary apparatus is cleaned.Then apparatus is carried out disinfection.In a kind of sterilization technology, apparatus is placed in close and sealing container, such as plastics or in pocket.Then container and apparatus are placed in the radiation area that can penetrate this container, such as gamma-radiation, x-ray or high energy electron.Antibacterial on apparatus and in container kills by radiation.Then the apparatus after sterilizing is kept in disinfecting container.Apparatus is kept aseptic by sealing container, until open this container in armarium.Other disinfection technology is undertaken by any various ways well known by persons skilled in the art, comprises β radiation, gamma-radiation, oxirane and/or steam.

Although be described in conjunction with the various embodiments of embodiment to device disclosed in some in literary composition, many modification of these embodiments and modification also can be implemented.Such as, dissimilar end effector can be adopted.In addition, every situation disclosing material for some assembly, all can use other material.Above-mentioned explanation and following claim are intended to contain all this kind of modification and modification.

With way of reference in full or be partly incorporated to any patent herein, announcement or other open material and all only with in existing definition of the present invention, statement or the afoul scope of other open material be not incorporated to herein at be incorporated to material.Thus, under the degree of necessity, the disclosure clearly set forth herein will replace any material that conflicts mutually be 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, be incorporated to herein under only not producing the degree of conflict between be incorporated to material and existing open material.

Claims

1., for providing a surgical instruments for energy to tissue, comprising:

Trigger; With

Electrical input;

From the axle that shank extends, 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:

First jaw member;

Second jaw member, at least one in wherein said first jaw member and described second jaw member can be moved between the open position and the closed position relative to the another one in described first jaw member and described second jaw member, to clamp the tissue in the middle of described first jaw member and described second jaw member when being in described make position;

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

Comprise the cutting element of 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 along described passage at advanced position and advance translation between position completely, described cutting element comprises at least the first band, the second band and the 3rd band, wherein said second band be arranged on described first band and the 3rd band middle and comprise sharp keen distal incision element; With

From at least one compressing member that described cutting element extends, at least one compressing member wherein said engages the one in described first jaw member and the second jaw member, moves to described make position to make described first jaw member and the second jaw member when described cutting element moves to outside described advanced position relative to described first jaw member from described open position.

2. surgical instruments according to claim 1, described first jaw member comprises the first track and described second jaw member comprises the second track, and at least one compressing member wherein said comprises along the first compressing member of described first orbital motion and the second compressing member along described second orbital motion.

3. surgical instruments according to claim 2, wherein said first track comprises the first distally stop part to engage described first compressing member, and described second track comprises the second distally stop part to engage described second compressing member.

4. surgical instruments according to claim 2, wherein said passage extends farther than described first track and the second track along distal direction.

5. surgical instruments according to claim 1, wherein said first band and the 3rd band comprise the funnel shaped part of contiguous described sharp keen distal incision element.