CN103747752A - 基于能量的剪刀装置 - Google Patents
基于能量的剪刀装置 Download PDFInfo
- Publication number
- CN103747752A CN103747752A CN201280025118.9A CN201280025118A CN103747752A CN 103747752 A CN103747752 A CN 103747752A CN 201280025118 A CN201280025118 A CN 201280025118A CN 103747752 A CN103747752 A CN 103747752A
- Authority
- CN
- China
- Prior art keywords
- shank
- actuation member
- outer tube
- inner tube
- yoke
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 210000003414 extremity Anatomy 0.000 claims description 32
- 210000003813 thumb Anatomy 0.000 claims description 29
- 230000033001 locomotion Effects 0.000 claims description 19
- 230000005540 biological transmission Effects 0.000 claims description 17
- 210000003811 finger Anatomy 0.000 claims description 9
- 230000007246 mechanism Effects 0.000 abstract description 11
- 230000015271 coagulation Effects 0.000 abstract description 7
- 238000005345 coagulation Methods 0.000 abstract description 7
- 238000001356 surgical procedure Methods 0.000 abstract description 7
- 238000002324 minimally invasive surgery Methods 0.000 abstract description 3
- 238000002224 dissection Methods 0.000 abstract description 2
- 238000010276 construction Methods 0.000 abstract 1
- 239000012636 effector Substances 0.000 description 27
- 230000004048 modification Effects 0.000 description 18
- 238000012986 modification Methods 0.000 description 18
- 238000013519 translation Methods 0.000 description 11
- 230000014616 translation Effects 0.000 description 11
- 239000000463 material Substances 0.000 description 9
- 230000008859 change Effects 0.000 description 7
- 230000006835 compression Effects 0.000 description 6
- 238000007906 compression Methods 0.000 description 6
- 238000005452 bending Methods 0.000 description 4
- 229920000106 Liquid crystal polymer Polymers 0.000 description 3
- 239000004696 Poly ether ether ketone Substances 0.000 description 3
- 210000005224 forefinger Anatomy 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 239000004033 plastic Substances 0.000 description 3
- 229920003023 plastic Polymers 0.000 description 3
- 229920002530 polyetherether ketone Polymers 0.000 description 3
- 229920001169 thermoplastic Polymers 0.000 description 3
- 239000004416 thermosoftening plastic Substances 0.000 description 3
- 238000002604 ultrasonography Methods 0.000 description 3
- 239000004734 Polyphenylene sulfide Substances 0.000 description 2
- 230000009471 action Effects 0.000 description 2
- 230000003321 amplification Effects 0.000 description 2
- 238000000354 decomposition reaction Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 210000004247 hand Anatomy 0.000 description 2
- 238000002955 isolation Methods 0.000 description 2
- 238000003199 nucleic acid amplification method Methods 0.000 description 2
- 229920000069 polyphenylene sulfide Polymers 0.000 description 2
- 239000011347 resin Substances 0.000 description 2
- 229920005989 resin Polymers 0.000 description 2
- CVOFKRWYWCSDMA-UHFFFAOYSA-N 2-chloro-n-(2,6-diethylphenyl)-n-(methoxymethyl)acetamide;2,6-dinitro-n,n-dipropyl-4-(trifluoromethyl)aniline Chemical compound CCC1=CC=CC(CC)=C1N(COC)C(=O)CCl.CCCN(CCC)C1=C([N+]([O-])=O)C=C(C(F)(F)F)C=C1[N+]([O-])=O CVOFKRWYWCSDMA-UHFFFAOYSA-N 0.000 description 1
- 229910017083 AlN Inorganic materials 0.000 description 1
- PIGFYZPCRLYGLF-UHFFFAOYSA-N Aluminum nitride Chemical compound [Al]#N PIGFYZPCRLYGLF-UHFFFAOYSA-N 0.000 description 1
- 229910052582 BN Inorganic materials 0.000 description 1
- PZNSFCLAULLKQX-UHFFFAOYSA-N Boron nitride Chemical compound N#B PZNSFCLAULLKQX-UHFFFAOYSA-N 0.000 description 1
- 239000004977 Liquid-crystal polymers (LCPs) Substances 0.000 description 1
- 210000000683 abdominal cavity Anatomy 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 210000000080 chela (arthropods) Anatomy 0.000 description 1
- 230000001112 coagulating effect Effects 0.000 description 1
- 230000008878 coupling Effects 0.000 description 1
- 238000010168 coupling process Methods 0.000 description 1
- 238000005859 coupling reaction Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000023597 hemostasis Effects 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 210000004932 little finger Anatomy 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000005457 optimization Methods 0.000 description 1
- 229920002492 poly(sulfone) Polymers 0.000 description 1
- 238000012546 transfer Methods 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/2816—Pivots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
- A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320072—Working tips with special features, e.g. extending parts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320072—Working tips with special features, e.g. extending parts
- A61B2017/320074—Working tips with special features, e.g. extending parts blade
- A61B2017/320075—Working tips with special features, e.g. extending parts blade single edge blade, e.g. for cutting
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320093—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing cutting operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Mechanical Engineering (AREA)
- Biomedical Technology (AREA)
- Dentistry (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
本发明提供了一种基于能量的外科器械,该基于能量的外科器械能够允许细小和精密外科手术中所需的选择性切割、凝固和细小解剖。剪刀夹持器械提供管中管构造(60,70),因此装置可用于开放性手术和微创手术两者。所述组件包括夹紧机构,所述夹紧机构包括夹持臂和/或外壳,所述夹持臂和/或外壳具体能够产生期望量级的组织夹持力。
Description
优先权
本专利申请要求于2011年3月24日提交的、名称为“UltrasonicDevice for Cutting and Coagulating”的美国临时专利申请序列号61/467,180的优先权。
技术领域
本发明一般涉及外科系统,更具体地讲,涉及优化的以允许外科医生在开放式手术和微创手术中进行细小和精密手术操作时所需的切割、凝固和细小解剖的基于能量的装置。
背景技术
基于能量的外科器械凭借这种器械的独特的性能特性而在外科手术中日益得到广泛的应用。根据具体器械构型和操作参数,基于能量的外科器械可通过凝固而基本上同时进行组织切割和止血,从而有利地使患者创伤最小化。切割动作通常通过在器械远端处的端部执行器来完成,该端部执行器将超声能量或射频能量传输到接触端部执行器的组织。具有这一性质的器械能够用于开放性外科用途、腹腔镜式或内窥镜式外科手术,包括机器人辅助手术。
已开发出包括夹具机构的基于能量的外科器械,以将组织保持在端部执行器中,以便将超声能量或射频能量联接到患者的组织。关于超声能量,这种装置(有时被称作凝固器钳剪或超声切断器)在美国专利号5,322,055、5,873,873和6,325,811中有所公开。外科医生启动夹持臂,以通过挤压手把或柄部而抵靠相对的钳口或刀来按压夹持垫。
附图说明
本发明的新颖特征特别在所附权利要求书中示出。然而,引用以下描述并结合附图可最好地理解本发明本身的构造和操作方法,在这些附图中:
图1A是示出了用于根据本发明的基于能量的外科器械的端部执行器旋转组件的一种表达的分解视图;
图1B是示出了图1A的根据本发明的外科器械的替代性管中管装置的分解视图;
图2A是本发明的基于能量的外科器械处于打开位置时的侧视图;
图2B描绘了图2A的器械处于闭合位置;
图2C是用于基于能量的剪刀夹持件外科器械的旋转组件的透视图,其中所述器械处于闭合位置;
图2D是图2C的器械处于打开位置时的透视图,其中箭头指示运动方向;
图3A和3B示出了根据本发明的替代致动构件连接装置的透视图;
图4A和4B示出了根据本发明的替代致动构件连接装置的透视图和侧视图;
图5是夹持臂组件的局部透视图;
图6是替代致动构件连接装置的透视图;
图7是图6的实施例的侧视图;
图8A是剪刀致动构件的平面图,该剪刀致动构件具有处于第一位置的力改性套管;
图8B描绘了图8A的致动构件,其中所述力改性套管处于第二位置;
图9A是基于能量的外科器械的侧视图,其描绘了力改性致动构件止挡件处于第一位置;
图9B描绘了图9A的致动构件止挡件处于第二位置;
图10A-10D描绘了基于能量的外科器械的侧视图和后视图,该外科器械采用力改性构件的另一种表达;
图11A-11C描绘了力改性构件的另一种表达的平面图;
图12A和12B描绘了力改性构件的另一种表达的侧视图;
图13A-13D描绘了致动构件力改性构件的另一种表达;
图14A是基于能量的端部执行器的平面图,该端部执行器采用滑动通道来改性端部执行器的夹持力;
图14B描绘了图14A的端部执行器处于第一夹持位置;
图14C描绘了图14A的端部执行器处于第二夹持位置;和
具体实施方式
在详细阐述本发明之前,应该指出的是,本发明的应用或使用并不局限于附图和具体实施方式中详细示出的部件的构造和布置。本发明的示例性实施例可以实施或结合到其他实施例、改变和变型中,并可以多种方式实施或执行。此外,除非另外指明,本文所用的术语和表达是为了方便向读者描述本发明的示例性实施例的目的而选择的,并不是为了限制本发明。
此外,应当理解,下述实施例、实施例表达、例子等中的任何一个或多个可与下述其他实施例、实施例表达、例子等中的任何一个或多个结合。
本发明尤其涉及改进的基于能量的外科夹紧凝固器设备,其能够在开放性手术和微创手术中进行外科手术(包括精密外科手术)期间进行组织切割、凝固和/或夹持。解剖的选择性使用以及射频能量或超声能量的选择性使用有利于实现多种用途。当该设备的射频组件或超声组件为非活动时,可根据需要容易地夹持和操纵组织,而不进行组织切割或造成损害。当射频组件或超声组件被分开或统一激活时,该设备允许组织被抓持用于与能量联接,以进行组织凝固,并施加增加的压力,从而有效地进行组织切割和凝固。如果需要,可以在不使用设备的夹紧机构的情况下,通过适当操纵超声刀来将超声能量施加到组织。
从以下描述将显而易见的是,本发明的夹紧凝固器设备由于其简明的构造而特别能够一次性使用。这样,可以设想将该设备与外科系统的超声和/或射频发生器单元相连使用,从而来自发生器单元的能量向本发明的夹紧凝固器设备提供期望的致动。应当理解,体现本发明的原理的夹紧凝固器设备能够非一次性使用或多次使用,并且与相关发生器单元不可拆卸地一体化。还应理解,本发明可以非拴系方式完全包含电池和能量发生器,这在本领域中是已知的且能够被理解。参见美国专利公开2011/0015660,该专利公开的内容以引用的方式并入本文。
根据下文的说明将显而易见的是,本发明的夹紧凝固器设备提供利用管中管构造来抵靠刀打开和闭合夹持机构的替代实施例。在如美国专利公开2007/0191713中所公开的医疗装置中,可使用此种实施例来取代现有的剪刀型闭合机构,该美国专利公开的内容以引用的方式并入本文。
参见图1A,其示出了基于能量的外科器械10的第一种表达。器械10以剪刀形式布置,并包括致动构件15,该致动构件具有设置在构件15的近端处的拇指环20。构件15的远端处设置有枢轴组件。
基于能量的外科器械10包括多部件柄部组件50,该多部件柄部组件由柄部部件或护罩50A,50B构成,在超声能量的情形中,所述柄部部件或护罩能够将操作者与可能位于外壳50A,50B内的声音组件的振动隔离。当器械10采用射频能量时,外壳50能够将操作者与外壳中的电连接件隔离。柄部组件50的形状可设定成供使用者握住的传统剪刀装置,如本文所述。柄部50的近端能够容纳声音换能器(未示出)的远端。作为另外一种选择或相结合地,柄部50能够容纳至射频发生器的电连接件,或者能够保持发生器和电源,以实现非拴系式的超声和/或射频操作,这在本领域中是已知的且能够被理解。
图1A和1B中所述的剪刀组件(具体地讲为柄部组件50、致动构件15、拇指环20、指环200和旋钮45)可由耐用塑料(诸如聚碳酸酯或液晶聚合物)构成。也可设想剪刀组件可以作为另外一种选择由包括其他塑料、陶瓷或金属的多种材料制成。然而,传统的未填充热塑性塑料具有仅为约0.20W/m°K(瓦特/米-°开)的导热率。为改善器械的散热性,柄部组件可由热传导的热塑性塑料构成,诸如高耐热性的树脂液晶聚合物(LCP)、聚苯硫醚(PPS)、聚醚醚酮(PEEK)和聚砜,所述塑料具有介于20-100W/m°K范围内的热导率。PEEK是填充有不导电的氮化铝和氮化硼的热塑性塑料。导热树脂有助于管理较小器械内的热量。
致动构件15的远端包括枢轴组件25,该枢轴组件接合外壳50侧表面上的环55A,55B,以允许致动构件15实现剪刀动作。尽管显示为单独的组件15,25,然而可设想致动构件15与枢轴组件25可为一体的构造或者可包括不同材料的区段。连接件30的远端枢转地连接至枢轴组件25的内部,以有利于从致动构件传递力。连接件30的近端还进一步枢转地连接至轭35。枢轴组件25与外壳50之间的枢转连接限定轴线26,致动构件15围绕该轴线旋转。
在操作中,致动构件15以朝向和远离柄部50的方式运动,使得其围绕轴线26枢转,继而使连接件30沿远侧到近侧或近侧到远侧的纵向(取决于致动构件15的运动方向)而运动。连接件30的纵向运动导致轭35沿柄部50的纵向轴线210纵向平移,如本文将更详细地描述。
在器械10的一种表达中,轭35呈环形形状,而且还设有中间表面沟槽35A。在一种表达中,轭35部分地围绕传送连接件40的远端,如图1A和1B所示。轭35的中间表面沟槽35A能够容纳并接合传送连接件40的径向突出的导轨40A。轭35和导轨40A相互配合,以允许传送连接件40在轭35中旋转,还允许将来自连接件30的纵向力通过轭35传送到传送连接件40。
传送连接件40还设有纵向导轨或花键40B,所述导轨或花键能够接合旋钮45的中间表面纵向沟槽45C(如旋钮半件45A和45B所示)。导轨40B和旋钮沟槽45C能够允许传送连接件40在旋钮45中轴向平移,并允许将旋转力从旋钮45传送到传送连接件40。为提供旋钮45和传送连接件40的稳定性,旋钮45在旋钮45的中间表面中设有近侧环形沟槽45D。沟槽45D能够旋转地接合柄部凸缘50C,从而将旋钮45沿纵向轴线210保持在固定的纵向位置。
仍参见图1A,器械10还设有端部执行器轴组件65。在此种表达中,轴组件65包括外管66和内管60,其中允许内管60相对于外管66纵向平移。
内管60和外管66枢转地连接至内管60和外管66的远端处的夹持臂(未示出)。内管60的尺寸设定成允许超声波导穿过其中而通过,或者允许器械10在其中利用射频能量的电极导管通过。此种夹持臂致动管中管装置公开于美国专利号5,944,737、5,954,736、5,980,510和6,068,647中,所述专利的全部内容以引用的方式并入本文。
内管60设有凹陷75,该凹陷能够容纳传送连接件40的内表面(未示出)上的中间突出,从而允许将轴线运动从传送连接件40传送到内管60。轴组件65设有销70,该销延伸穿过外管66和内管60中的孔。在器械10的此种表达中,销70基本上垂直于轴65的纵向轴线。为有利于内管60相对于外管66的纵向平移,内管60的销孔可为纵向细长的。当旋钮45旋转时,传送连接件40继而旋转,从而旋转内管60。旋转力经由销70被传送到外管66,以有利于旋钮45、传送连接件40、内管60和外管66一体地旋转。
现在参见图1B,其中显示基于能量的外科器械10的第二种表达。在此种表达中,器械10能够与超声组件165一起使用。与先前的表达相似,器械10利用管中管构造来致动端部执行器,该端部执行器可为超声夹持臂。
在图1B的表达中,夹持力从枢轴组件25平移到连接件30和轭35。轭35纵向平移,从而使传送连接件40以上述方式纵向运动。如图1B所示,传送连接件40设有孔140A,所述孔能够与内管170上的孔170A对齐。可将销(未示出)插入到孔170A和140A中,以将内管170接合到传送连接件40。作为另外一种选择,传送连接件40可设有凹坑,所述凹坑与内管170上的中间突出配合。此种接合能够将纵向力从轭35传送到传送连接件40并到达内管170,从而致动端部执行器。
外管180设有近侧凸缘175A和175B,所述近侧凸缘接合传送连接件40的远侧中间表面上的纵向沟槽(未示出)。远侧中间沟槽的尺寸设定成允许传送连接件40沿凸缘175A和175B纵向平移,并允许旋转力从旋钮45经过传送连接件40而传送到外管180。
如图1B所示,声音组件165可设有环和穿过环的销。所述销的尺寸设定成长度大于声音组件165波导的直径,使得端部部分存在于声音组件165的侧表面的侧面。所述销还能够承坐在传送连接件40的中间表面上的通道中,以允许同时将旋转力从旋钮45传送到内管170、外管180和声音组件165,使得附接到内管170和外管180两者的夹持臂(未示出)与超声刀165A以固定的相对位置旋转。此种装置在美国专利号。6,068,647中有所公开,该专利的全部公开内容以引用方式并入本文。
图2A和2B描绘了上述驱动机构如何将指环20和200的剪刀型运动转换成传送连接件40沿纵向轴线210的来回侧向运动,该纵向轴线由外管66,180和外壳50限定。此种侧向运动使传送连接件40如图2A所示朝远侧运动,从而使夹持臂打开。相似地,如图2B所示闭合剪刀会使传送连接件沿轴线210朝近侧平移,从而使端部执行器夹持臂闭合。图2C和2D显示了器械10打开和闭合的放大等距剖面图。当致动构件15远离外壳50运动时(由箭头250标识),传送连接件40、连接件30和轭35的行进方向由图2D中的箭头260表示。
在使用中,外科医生或操作者将器械10放在其手掌中。器械10的尺寸可设定成舒适地配合在多种尺寸的成年人手掌中。可通过以下方式来操作器械10:将拇指放置在拇指环20中,并使手指围绕外壳50和/或穿过指环200而与拇指相对。外科医生通过分别远离和朝向器械运动拇指环而实现器械10的打开和闭合。器械10还能够单手操作,在单手操作中,旋钮被放置成允许外科医生利用握持器械10的手的食指来运动旋钮45。当被外科医生握持时,器械的致动构件15侧可被称为器械的顶部,且柄部50为器械的底部。柄部50可设有按钮,以允许通过抓紧器械10的手的食指或中指来激活供给端部执行器的能量。按钮可在柄部50的下侧上邻近旋钮45(柄部50的与致动构件15相对的部分被标识为参考编号220),以允许外科医生用食指或中指来启动器械。此种实施例允许在如美国专利公开2007/0191713中所公开的此种医疗装置中对现有的剪刀型闭合机构的端部执行器进行单手旋转和致动。
图3A和图3B中显示了器械10的另一种表达。在此种表达中,枢转轴线300基本上穿过纵向轴线210,且连接件30附接到致动构件15的顶部部分并位于枢转轴线300的远侧。图3A-3B的表达利用连接件30和轭35来将装置的打开和闭合剪刀运动转换成内管的纵向来回运动。
现在参见图4A和图4B,其中描绘了力传送组件的另一种表达。在此种表达中,连接件30放置在器械的下侧上。致动构件15围绕枢转轴线400的运动导致连接件30纵向平移轭35,从而平移传送连接件40(未示出)和内管60或170,从而运动设置在端部执行器处的夹具。在此种装置中,连接件30放置在柄部50的下侧上(朝向操作者的小指和无名指),此可改善操作者对其的可视性。
图3和图4中所描绘的连接件组件由于枢转轴线和连接件30的相对位置而使连接件30和轭35沿与图1-图2所示者相反的纵向而运动。图5描绘了用于与图3-4所示的机构一起使用的管中管/夹持臂装置的一种布置方式。如图所示,夹持臂510在枢轴接头500处枢转地附接到外管565。与轭35和传送连接件40机械连通的内管在其远端处设有U形托架520,该托架经由连接件530枢转地连接至夹持臂510。在此种装置中,纵向力从托架520通过连接件530而被传送到夹持臂510,从而使夹持臂510围绕枢转轴线500A旋转。在本领域中已知且能够理解的是,通过改变夹持臂510和托架520的取向,可将图5的夹持臂组件与图1和图2所示的器械10的表达一起使用。
现在参见图6和图7,其中显示了传送连接组件的另一种表达。在图6的表达中,器械10在基本上相对的侧外表面上设有附接到轭635的两个连接件630A和630B。在此种装置中,连接件630A,630B在轴线600A上围绕轭635枢转,该轴线穿过器械10的纵向轴线610。此种装置可具有不对轭35施加旋转力矩的期望效果,此可允许更顺利地将力从致动构件15传送到传送连接件40和内管60,170。尽管图6的表达描绘了两个连接件630A和630B,然而可设想器械10可采用仅一个连接件630A。
在上述表达中,致动构件15围绕柄部50上的点进行枢转。可期望在外壳50上设置止挡件或支点,以供致动构件50在器械10闭合时接合。在一种表达中,致动构件15接触轭35的凸缘35B(参见图2B),以防止拇指环20接触或抵靠至柄部50。当致动构件15由刚性材料制成时,拇指环20朝向外壳50的另外凹陷将通过连接件30、轭35、传送连接件40施加更多的力并最终到器械10的端部执行器上的夹持臂,但是可能不会导致拇指环20抵靠到柄部50上。在夹持臂处施加过大夹持压力的能力会导致在手术操作中利用器械10时产生不期望的组织效果。当致动构件15由柔性材料制成时,随着在接触凸缘35B之后施加更多的力,拇指环20可挠曲或弯曲并抵靠外壳50。施加到夹持臂的力的大小由支点相对于致动构件-柄部枢轴点的位置以及致动构件15的组成和横截面部分地决定。
参见图8A和图8B,致动构件15显示有狭窄部分800。在此种装置中,致动构件15可在夹持臂处施加较少的力,这是因为部分800可由于其相对于致动构件15的其他部分较小的横截面而在较小负荷下挠曲或弯曲。当需要较大的夹持力时,可运动衬圈810来覆盖部分800并防止挠曲或弯曲,如图8B所示。衬圈810可选自可兼容地用于外科的多种材料,且其尺寸应设定成基本上防止致动构件15在部分800处的弯曲。可设想,此种致动构件可与上文所示的器械10的任一种表达一起使用,且还可用于任何剪刀型器械上。还可设想,狭窄部分800的材料可不同于致动构件15的邻近狭窄部分800的部分。
图9A和9B示出了用于改性由致动构件15施加的夹持力的替代表达。在此种表达中,器械10设有止挡件900,该止挡件可沿柄部50的纵向轴线运动。止挡件900可承坐于外壳50中的通道(未示出)中,该通道在端部执行器处具有与已知的夹持力相关联的多个棘爪,其中每个棘爪将止挡件900放置在相对于拇指环20的不同纵向位置处。当止挡件900在沿近侧至远侧的方向运动时,致动构件15所施加的力会增大,其中图9B描绘了最小夹持力,且图9A描绘了拇指环20抵靠柄部50时的最大夹持力。
图10A-10D示出了用于与剪刀型器械一起使用的夹持力改性机构的另一种表达。器械10在外壳50的近端处设有凸轮构件1000。凸轮构件1000旋转地附接到外壳50,以选择性地改变拇指环20的抵靠点,此继而会改变致动构件15可施加的夹持力的大小。凸轮构件1000和外壳50可设有棘爪,使得凸轮构件1000将棘轮呈环形安装至固定位置,从而使拇指环在与已知夹持力相关联的已知位置处进行抵靠。图12B描绘了最小夹持力装置,而图12D描绘了最大夹持力装置。还设想凸轮构件1000可在凸轮1000的侧表面上设有与拇指环20的侧表面配合的台阶或架子,以允许凸轮1000与拇指环20之间更好地接合。
图11A-11C中示出了夹持力改性机构的替代表达。止动销1100由滑动凸轮1110控制,以使止动销1100选择性地与拇指环20接合或脱离,以增大或减小端部执行器处的压缩力。可通过布置穿过外壳50而突起的正交突出部(未示出)来手动地启动滑动凸轮1110。突出部可利用与已知销1100的高度相关联的棘爪而承坐于外壳50中的狭槽中,所述棘爪的高度还与已知的夹持力相关联。作为另外一种选择,可通过提供由按钮或开关控制的马达和齿轮组件来使滑动凸轮1110自动化。作为另外一种选择,滑动凸轮1110可具有如图11C所示的不止一个凸轮斜面,以在端部执行器处提供可变的压缩力。
在夹持力改性机构的又一替代表达中,图12A-12B示出了由滑动凸轮1210控制的止动销1200,该滑动凸轮由压缩弹簧1220偏置。滑动凸轮1210和弹簧1220容纳在外壳50的通道1230中。在第一状态中,止动销1200接合拇指环20以限制端部执行器处的压缩力。如果外科医生继续向下按压止动销1200,则销1200会沿凸轮斜面向下滑动,并迫使滑动凸轮1210在通道1230中朝近侧平移以压缩弹簧1220。销1230最终抵靠通道1230,从而防止销1200进一步运动,如图12B所示。利用滑动凸轮1210和弹簧1220,力反馈通过与拇指环20接触的销1200而被引导至外科医生。压缩该弹簧1220所需力的逐渐增大可导致端部执行器处的压缩力可变地增大。
拇指环20可设有活动的止动销,以选择性地改变端部执行器处的夹持力,如图13A-D所示。止动销1300可滑动地安装至拇指环20的下侧面。在操作中,当止动销1300处于最远侧位置时(如图13A所示),外科医生可能期望比可得的力更大的夹持力。通过选择性地从最远侧位置旋转或运动止动销1300(如图13B和13C所示),可使拇指环接触或抵靠在柄部50上,如图13D所示。在一种表达中,止动销1300可承坐在设在拇指环20的下部中的通道(未示出)中。尽管被显示为基本上矩形的,然而在本领域中已知且能够理解的是,止动销1300可为圆的以提供凸轮表面,且拇指环20可在止动销1300的通道中设有棘爪,以允许止动销1300进行选择性运动,从而进一步允许其凸轮表面与柄部50之间进行选择性地接合,从而递增地改变端部执行器夹持力。
在夹持力改性机构的又一替代表达中,图14A-14C示出了放大的枢轴狭槽,由此致动构件上的枢轴点可被增长或缩短,以改变致动构件与柄部之间的力矩臂,且因此改变端部执行器处的压缩力。
在图14的表达中,致动构件1315设有圆孔1335和1340。如图所示,孔1335和1340的半径交叠,从而在夹持臂1315中形成放大的枢轴狭槽1345。柱销1330被定位成正交于端部执行器轴线1300。柱销1330的形状设定成允许夹持臂1315枢轴点在孔1335和1340之间运动。如图所示,柱销1330是椭圆形的,但也可根据枢轴狭槽1345的构型而设想出其他形状。在第一位置中,致动构件运动至允许孔1340接合柱销1330并围绕柱销1330旋转,如图14B所示。此第一位置在端部执行器1325与夹具1350之间形成第一压缩力。在第二位置中,夹持臂运动成允许枢轴狭槽1345相对于柱销1330平移,并还允许柱销1330接合孔1335,从而在端部执行器1325与夹持臂1350之间形成第二力,如图14C所示。通过在枢轴组件25的两侧上采用枢轴狭槽1345,并进一步在外壳50的侧表面上提供柱销1330来接合枢轴狭槽1345,此种装置可与前述器械10一起被采用。
尽管已经通过描述若干实施例说明了本发明,但申请人并非旨在将所附权利要求书的实质和范围限定或限制到这些细节上。在不脱离本发明的范围的条件下,本领域的技术人员可以作出各种变型、改变和置换。此外,作为另外一种选择,可将与本发明相关的每一个元件的结构描述为用于提供由该元件执行的功能的装置。
已经示出和描述了本发明的多个实施例和例子,可由本领域普通技术人员进行适当修改来实现本文描述的方法和设备的进一步改进而不脱离本发明的范围。已经提及了若干此类潜在的修改形式,并且其他修改形式对于本领域的技术人员而言将显而易见。例如,附图的具体材料、量纲和比例将会被理解为非限制性实例。还应当理解,本文所述的各种表达可相互组合,这在本领域中是已知的且能够被理解。因此,本发明的范围应以下面的权利要求书考虑,并且应理解为不限于说明书和附图中示出和描述的结构、材料或操作的细节。
Claims (20)
1.一种外科器械,包括:
中空的外管,所述外管限定纵向轴线;
夹持臂,所述夹持臂枢转地连接至所述外管;
内管,所述内管基本上设置在所述外管内,所述内管枢转地连接至所述夹持臂并能够相对于所述外管纵向滑动;
柄部,所述柄部具有沿所述纵向轴线设置的近端和远端;
致动构件,所述致动构件枢转地安装至所述柄部;
连接臂,所述连接臂枢转地附接到所述致动构件;
轭,所述轭枢转地附接到所述连接臂;以及
传送连接件,所述传送连接件在所述柄部的远端中围绕所述纵向轴线设置,所述传送连接件能够相对于所述柄部纵向滑动并纵向接合所述轭,所述传送连接件固定地附接到所述内管并可旋转地接合所述外管。
2.根据权利要求1所述的器械,其中所述传送连接件包括圆柱体,所述圆柱体具有环形中间表面和环形侧表面。
3.根据权利要求2所述的器械,还包括在所述传送连接件的侧表面上纵向延伸的至少一个导轨。
4.根据权利要求3所述的器械,还包括部分地围绕所述传送连接件的环形侧表面设置的旋钮,其中所述旋钮具有至少一个纵向中间凹槽,所述至少一个纵向中间凹槽与所述传送连接件的至少一个导轨配合。
5.根据权利要求4所述的器械,其中所述传送连接件还包括围绕所述传送连接件的远端呈环形设置的突出导轨。
6.根据权利要求5所述的器械,其中所述轭具有环形凹槽,所述环形凹槽与所述传送连接件的呈环形设置的突出导轨配合。
7.根据权利要求6所述的器械,还包括设置在所述柄部的近端处的指环。
8.根据权利要求7所述的器械,还包括设置在所述致动构件的近端处的拇指环。
9.一种外科器械,包括:
中空的外管,所述外管限定纵向轴线;
夹持臂,所述夹持臂枢转地连接至所述外管;
内管,所述内管基本上设置在所述外管内,所述内管枢转地连接至所述夹持臂并能够相对于所述外管纵向滑动;
柄部,所述柄部具有沿所述纵向轴线设置的近端和远端;
致动构件,所述致动构件枢转地安装至所述柄部;
连接臂,所述连接臂枢转地附接到所述致动构件;
轭,所述轭枢转地附接到所述连接臂;以及
固定地附接到所述内管并旋转地接合所述外管的装置,用于传送来自所述致动构件的纵向力和来自旋钮的旋转力。
10.根据权利要求9所述的器械,还包括设置在所述柄部的近端处的指环。
11.根据权利要求10所述的器械,还包括设置在所述致动构件的近端处的拇指环。
12.根据权利要求11所述的器械,其中外壳近端设有用于选择性地接合所述拇指环的装置。
13.根据权利要求10所述的器械,还包括止动销,所述止动销可滑动地附接到所述拇指环,其中所述止动销选择性地接合所述柄部。
14.一种外科器械,包括:
中空的外管,所述外管限定纵向轴线;
夹持臂,所述夹持臂枢转地连接至所述外管;
内管,所述内管基本上设置在所述外管内,所述内管枢转地连接至所述夹持臂并能够相对于所述外管纵向滑动;
柄部,所述柄部具有侧表面以及近端和远端,所述柄部沿所述纵向轴线设置,所述柄部具有设置在所述侧表面上的柱销;
致动构件,所述致动构件具有枢转地接合所述柄部的柱销的狭槽;
连接臂,所述连接臂枢转地附接到所述致动构件;
轭,所述轭枢转地附接到所述连接臂;以及
传送连接件,所述传送连接件在所述柄部的远端中围绕所述纵向轴线设置,所述传送连接件能够相对于所述柄部纵向滑动并纵向接合所述轭,所述传送连接件固定地附接到所述内管并可旋转地接合所述外管。
15.根据权利要求14所述的器械,其中所述狭槽由具有交叠半径的两个圆孔构成。
16.根据权利要求15所述的器械,还包括凸轮,所述凸轮旋转地附接到所述柄部的近端,其中所述凸轮选择性地接合所述拇指环。
17.根据权利要求14所述的器械,还包括在外壳中的纵向通道,所述通道中可滑动地安装有楔,所述楔具有接合止动销的凸轮表面,所述止动销基本上正交于所述通道布置,所述通道还具有弹簧,所述弹簧在与所述凸轮表面相对的端部处附接到所述楔。
18.根据权利要求14所述的器械,其中所述致动构件具有第一横截面和第二横截面,其中所述第二横截面小于所述第一横截面。
19.根据权利要求18所述的器械,还包括衬圈,所述衬圈基本上包围所述第二横截面,所述衬圈能够相对于所述致动构件滑动。
20.根据权利要求19所述的器械,其中所述衬圈可滑动地附接到所述致动构件。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161467180P | 2011-03-24 | 2011-03-24 | |
US61/467,180 | 2011-03-24 | ||
PCT/US2012/029924 WO2012129292A2 (en) | 2011-03-24 | 2012-03-21 | Energy-based scissors device |
Publications (2)
Publication Number | Publication Date |
---|---|
CN103747752A true CN103747752A (zh) | 2014-04-23 |
CN103747752B CN103747752B (zh) | 2017-04-26 |
Family
ID=45932512
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN201280025118.9A Expired - Fee Related CN103747752B (zh) | 2011-03-24 | 2012-03-21 | 基于能量的剪刀装置 |
Country Status (6)
Country | Link |
---|---|
US (1) | US8974447B2 (zh) |
EP (1) | EP2688496B8 (zh) |
JP (1) | JP6067670B2 (zh) |
CN (1) | CN103747752B (zh) |
BR (1) | BR112013024523B1 (zh) |
WO (1) | WO2012129292A2 (zh) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN106999240A (zh) * | 2015-04-30 | 2017-08-01 | 奥林巴斯株式会社 | 处置器具 |
CN108348271A (zh) * | 2015-10-19 | 2018-07-31 | 伊西康有限责任公司 | 具有双模式端部执行器和侧装夹持臂组件的外科器械 |
Families Citing this family (136)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10835307B2 (en) | 2001-06-12 | 2020-11-17 | Ethicon Llc | Modular battery powered handheld surgical instrument containing elongated multi-layered shaft |
US8182501B2 (en) | 2004-02-27 | 2012-05-22 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical shears and method for sealing a blood vessel using same |
EP3162309B1 (en) | 2004-10-08 | 2022-10-26 | Ethicon LLC | Ultrasonic surgical instrument |
US20070191713A1 (en) | 2005-10-14 | 2007-08-16 | Eichmann Stephen E | Ultrasonic device for cutting and coagulating |
US7621930B2 (en) | 2006-01-20 | 2009-11-24 | Ethicon Endo-Surgery, Inc. | Ultrasound medical instrument having a medical ultrasonic blade |
US8911460B2 (en) | 2007-03-22 | 2014-12-16 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8142461B2 (en) | 2007-03-22 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8057498B2 (en) | 2007-11-30 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument blades |
US8226675B2 (en) | 2007-03-22 | 2012-07-24 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8523889B2 (en) | 2007-07-27 | 2013-09-03 | Ethicon Endo-Surgery, Inc. | Ultrasonic end effectors with increased active length |
US8882791B2 (en) | 2007-07-27 | 2014-11-11 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8808319B2 (en) | 2007-07-27 | 2014-08-19 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US9044261B2 (en) | 2007-07-31 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Temperature controlled ultrasonic surgical instruments |
US8512365B2 (en) | 2007-07-31 | 2013-08-20 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8430898B2 (en) | 2007-07-31 | 2013-04-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
EP2217157A2 (en) | 2007-10-05 | 2010-08-18 | Ethicon Endo-Surgery, Inc. | Ergonomic surgical instruments |
US10010339B2 (en) | 2007-11-30 | 2018-07-03 | Ethicon Llc | Ultrasonic surgical blades |
US9089360B2 (en) | 2008-08-06 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
US9700339B2 (en) | 2009-05-20 | 2017-07-11 | Ethicon Endo-Surgery, Inc. | Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments |
US8650728B2 (en) | 2009-06-24 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Method of assembling a transducer for a surgical instrument |
US8663220B2 (en) | 2009-07-15 | 2014-03-04 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8956349B2 (en) | 2009-10-09 | 2015-02-17 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
USRE47996E1 (en) | 2009-10-09 | 2020-05-19 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US9168054B2 (en) | 2009-10-09 | 2015-10-27 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US11090104B2 (en) | 2009-10-09 | 2021-08-17 | Cilag Gmbh International | Surgical generator for ultrasonic and electrosurgical devices |
US10441345B2 (en) | 2009-10-09 | 2019-10-15 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US8579928B2 (en) | 2010-02-11 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Outer sheath and blade arrangements for ultrasonic surgical instruments |
US8486096B2 (en) | 2010-02-11 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Dual purpose surgical instrument for cutting and coagulating tissue |
US8469981B2 (en) | 2010-02-11 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Rotatable cutting implement arrangements for ultrasonic surgical instruments |
US8951272B2 (en) | 2010-02-11 | 2015-02-10 | Ethicon Endo-Surgery, Inc. | Seal arrangements for ultrasonically powered surgical instruments |
US8961547B2 (en) | 2010-02-11 | 2015-02-24 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with moving cutting implement |
GB2480498A (en) | 2010-05-21 | 2011-11-23 | Ethicon Endo Surgery Inc | Medical device comprising RF circuitry |
US8795327B2 (en) | 2010-07-22 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with separate closure and cutting members |
US9192431B2 (en) | 2010-07-23 | 2015-11-24 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US9259265B2 (en) | 2011-07-22 | 2016-02-16 | Ethicon Endo-Surgery, Llc | Surgical instruments for tensioning tissue |
EP2811932B1 (en) | 2012-02-10 | 2019-06-26 | Ethicon LLC | Robotically controlled surgical instrument |
US9226766B2 (en) | 2012-04-09 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Serial communication protocol for medical device |
US9237921B2 (en) | 2012-04-09 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
US9724118B2 (en) | 2012-04-09 | 2017-08-08 | Ethicon Endo-Surgery, Llc | Techniques for cutting and coagulating tissue for ultrasonic surgical instruments |
US9241731B2 (en) | 2012-04-09 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Rotatable electrical connection for ultrasonic surgical instruments |
US9439668B2 (en) | 2012-04-09 | 2016-09-13 | Ethicon Endo-Surgery, Llc | Switch arrangements for ultrasonic surgical instruments |
US20140005705A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulating shafts |
US20140005702A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with distally positioned transducers |
US9226767B2 (en) | 2012-06-29 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Closed feedback control for electrosurgical device |
US9351754B2 (en) | 2012-06-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Ultrasonic surgical instruments with distally positioned jaw assemblies |
US9283045B2 (en) | 2012-06-29 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Surgical instruments with fluid management system |
US9820768B2 (en) | 2012-06-29 | 2017-11-21 | Ethicon Llc | Ultrasonic surgical instruments with control mechanisms |
US9326788B2 (en) | 2012-06-29 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Lockout mechanism for use with robotic electrosurgical device |
US9393037B2 (en) | 2012-06-29 | 2016-07-19 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9198714B2 (en) | 2012-06-29 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Haptic feedback devices for surgical robot |
US9408622B2 (en) | 2012-06-29 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
JP6275727B2 (ja) | 2012-09-28 | 2018-02-07 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | 多機能バイポーラ鉗子 |
US10201365B2 (en) | 2012-10-22 | 2019-02-12 | Ethicon Llc | Surgeon feedback sensing and display methods |
US9095367B2 (en) | 2012-10-22 | 2015-08-04 | Ethicon Endo-Surgery, Inc. | Flexible harmonic waveguides/blades for surgical instruments |
US20140135804A1 (en) | 2012-11-15 | 2014-05-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic and electrosurgical devices |
US10226273B2 (en) | 2013-03-14 | 2019-03-12 | Ethicon Llc | Mechanical fasteners for use with surgical energy devices |
US9241728B2 (en) | 2013-03-15 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument with multiple clamping mechanisms |
TWM464137U (zh) * | 2013-07-03 | 2013-11-01 | Healthbanks Biotech Co Ltd | 具動力源之剪切裝置夾具總成 |
US9814514B2 (en) | 2013-09-13 | 2017-11-14 | Ethicon Llc | Electrosurgical (RF) medical instruments for cutting and coagulating tissue |
US9265926B2 (en) | 2013-11-08 | 2016-02-23 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
US9943325B2 (en) * | 2013-11-26 | 2018-04-17 | Ethicon Llc | Handpiece and blade configurations for ultrasonic surgical instrument |
WO2015081042A1 (en) | 2013-11-26 | 2015-06-04 | Ethicon Endo-Surgery, Inc. | Sleeve features for ultrasonic blade of a surgical instrument |
GB2521228A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
GB2521229A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
US9795436B2 (en) | 2014-01-07 | 2017-10-24 | Ethicon Llc | Harvesting energy from a surgical generator |
US9554854B2 (en) | 2014-03-18 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Detecting short circuits in electrosurgical medical devices |
US10463421B2 (en) | 2014-03-27 | 2019-11-05 | Ethicon Llc | Two stage trigger, clamp and cut bipolar vessel sealer |
US10092310B2 (en) | 2014-03-27 | 2018-10-09 | Ethicon Llc | Electrosurgical devices |
US9737355B2 (en) | 2014-03-31 | 2017-08-22 | Ethicon Llc | Controlling impedance rise in electrosurgical medical devices |
US9913680B2 (en) | 2014-04-15 | 2018-03-13 | Ethicon Llc | Software algorithms for electrosurgical instruments |
AU360519S (en) * | 2014-06-27 | 2015-03-03 | Nagaki Seiki Co | Wire grippers |
US10285724B2 (en) | 2014-07-31 | 2019-05-14 | Ethicon Llc | Actuation mechanisms and load adjustment assemblies for surgical instruments |
US9901360B2 (en) * | 2014-09-17 | 2018-02-27 | Ethicon Llc | Ultrasonic surgical instrument with retractable integral clamp arm |
US10433863B2 (en) | 2014-11-25 | 2019-10-08 | Ethicon Llc | Ultrasonic surgical instrument with blade cooling through retraction |
US10004529B2 (en) | 2014-11-25 | 2018-06-26 | Ethicon Llc | Features to drive fluid toward an ultrasonic blade of a surgical instrument |
US10206705B2 (en) | 2014-11-25 | 2019-02-19 | Ethicon Llc | Features for communication of fluid through shaft assembly of ultrasonic surgical instrument |
US10639092B2 (en) | 2014-12-08 | 2020-05-05 | Ethicon Llc | Electrode configurations for surgical instruments |
USD763674S1 (en) * | 2014-12-24 | 2016-08-16 | Nagaki Seiki Co., Ltd. | Wire gripper |
US10245095B2 (en) | 2015-02-06 | 2019-04-02 | Ethicon Llc | Electrosurgical instrument with rotation and articulation mechanisms |
US10342602B2 (en) | 2015-03-17 | 2019-07-09 | Ethicon Llc | Managing tissue treatment |
US10321950B2 (en) | 2015-03-17 | 2019-06-18 | Ethicon Llc | Managing tissue treatment |
US10595929B2 (en) | 2015-03-24 | 2020-03-24 | Ethicon Llc | Surgical instruments with firing system overload protection mechanisms |
US10034684B2 (en) | 2015-06-15 | 2018-07-31 | Ethicon Llc | Apparatus and method for dissecting and coagulating tissue |
US11020140B2 (en) | 2015-06-17 | 2021-06-01 | Cilag Gmbh International | Ultrasonic surgical blade for use with ultrasonic surgical instruments |
US10034704B2 (en) | 2015-06-30 | 2018-07-31 | Ethicon Llc | Surgical instrument with user adaptable algorithms |
US10357303B2 (en) | 2015-06-30 | 2019-07-23 | Ethicon Llc | Translatable outer tube for sealing using shielded lap chole dissector |
US11051873B2 (en) | 2015-06-30 | 2021-07-06 | Cilag Gmbh International | Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters |
US10898256B2 (en) | 2015-06-30 | 2021-01-26 | Ethicon Llc | Surgical system with user adaptable techniques based on tissue impedance |
US10765470B2 (en) | 2015-06-30 | 2020-09-08 | Ethicon Llc | Surgical system with user adaptable techniques employing simultaneous energy modalities based on tissue parameters |
US11129669B2 (en) | 2015-06-30 | 2021-09-28 | Cilag Gmbh International | Surgical system with user adaptable techniques based on tissue type |
US10154852B2 (en) | 2015-07-01 | 2018-12-18 | Ethicon Llc | Ultrasonic surgical blade with improved cutting and coagulation features |
US11033322B2 (en) | 2015-09-30 | 2021-06-15 | Ethicon Llc | Circuit topologies for combined generator |
US10595930B2 (en) | 2015-10-16 | 2020-03-24 | Ethicon Llc | Electrode wiping surgical device |
US10179022B2 (en) | 2015-12-30 | 2019-01-15 | Ethicon Llc | Jaw position impedance limiter for electrosurgical instrument |
US10575892B2 (en) | 2015-12-31 | 2020-03-03 | Ethicon Llc | Adapter for electrical surgical instruments |
US11129670B2 (en) | 2016-01-15 | 2021-09-28 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization |
US10716615B2 (en) | 2016-01-15 | 2020-07-21 | Ethicon Llc | Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade |
US10299821B2 (en) | 2016-01-15 | 2019-05-28 | Ethicon Llc | Modular battery powered handheld surgical instrument with motor control limit profile |
US11229471B2 (en) | 2016-01-15 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization |
US10555769B2 (en) | 2016-02-22 | 2020-02-11 | Ethicon Llc | Flexible circuits for electrosurgical instrument |
US10646269B2 (en) | 2016-04-29 | 2020-05-12 | Ethicon Llc | Non-linear jaw gap for electrosurgical instruments |
US10702329B2 (en) | 2016-04-29 | 2020-07-07 | Ethicon Llc | Jaw structure with distal post for electrosurgical instruments |
US10485607B2 (en) | 2016-04-29 | 2019-11-26 | Ethicon Llc | Jaw structure with distal closure for electrosurgical instruments |
US10456193B2 (en) | 2016-05-03 | 2019-10-29 | Ethicon Llc | Medical device with a bilateral jaw configuration for nerve stimulation |
US10245064B2 (en) | 2016-07-12 | 2019-04-02 | Ethicon Llc | Ultrasonic surgical instrument with piezoelectric central lumen transducer |
US10893883B2 (en) | 2016-07-13 | 2021-01-19 | Ethicon Llc | Ultrasonic assembly for use with ultrasonic surgical instruments |
US10842522B2 (en) | 2016-07-15 | 2020-11-24 | Ethicon Llc | Ultrasonic surgical instruments having offset blades |
US10376305B2 (en) | 2016-08-05 | 2019-08-13 | Ethicon Llc | Methods and systems for advanced harmonic energy |
US10285723B2 (en) | 2016-08-09 | 2019-05-14 | Ethicon Llc | Ultrasonic surgical blade with improved heel portion |
USD847990S1 (en) | 2016-08-16 | 2019-05-07 | Ethicon Llc | Surgical instrument |
US10952759B2 (en) | 2016-08-25 | 2021-03-23 | Ethicon Llc | Tissue loading of a surgical instrument |
US10736649B2 (en) | 2016-08-25 | 2020-08-11 | Ethicon Llc | Electrical and thermal connections for ultrasonic transducer |
US10603064B2 (en) | 2016-11-28 | 2020-03-31 | Ethicon Llc | Ultrasonic transducer |
US11266430B2 (en) | 2016-11-29 | 2022-03-08 | Cilag Gmbh International | End effector control and calibration |
US10820920B2 (en) | 2017-07-05 | 2020-11-03 | Ethicon Llc | Reusable ultrasonic medical devices and methods of their use |
WO2019188918A1 (ja) * | 2018-03-28 | 2019-10-03 | テルモ株式会社 | 医療デバイスおよび処置用法 |
US11607267B2 (en) * | 2019-06-10 | 2023-03-21 | Covidien Lp | Electrosurgical forceps |
CN110292411B (zh) * | 2019-08-06 | 2024-04-16 | 南微医学科技股份有限公司 | 一种组织夹闭装置 |
US11696776B2 (en) | 2019-12-30 | 2023-07-11 | Cilag Gmbh International | Articulatable surgical instrument |
US20210196358A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with electrodes biasing support |
US11589916B2 (en) | 2019-12-30 | 2023-02-28 | Cilag Gmbh International | Electrosurgical instruments with electrodes having variable energy densities |
US11812957B2 (en) | 2019-12-30 | 2023-11-14 | Cilag Gmbh International | Surgical instrument comprising a signal interference resolution system |
US11779329B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a flex circuit including a sensor system |
US11779387B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Clamp arm jaw to minimize tissue sticking and improve tissue control |
US11986201B2 (en) | 2019-12-30 | 2024-05-21 | Cilag Gmbh International | Method for operating a surgical instrument |
US11684412B2 (en) | 2019-12-30 | 2023-06-27 | Cilag Gmbh International | Surgical instrument with rotatable and articulatable surgical end effector |
US11937863B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Deflectable electrode with variable compression bias along the length of the deflectable electrode |
US11452525B2 (en) | 2019-12-30 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising an adjustment system |
US11937866B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Method for an electrosurgical procedure |
US11786291B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Deflectable support of RF energy electrode with respect to opposing ultrasonic blade |
US11759251B2 (en) | 2019-12-30 | 2023-09-19 | Cilag Gmbh International | Control program adaptation based on device status and user input |
US11950797B2 (en) | 2019-12-30 | 2024-04-09 | Cilag Gmbh International | Deflectable electrode with higher distal bias relative to proximal bias |
US11660089B2 (en) | 2019-12-30 | 2023-05-30 | Cilag Gmbh International | Surgical instrument comprising a sensing system |
US11944366B2 (en) | 2019-12-30 | 2024-04-02 | Cilag Gmbh International | Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode |
US11911063B2 (en) | 2019-12-30 | 2024-02-27 | Cilag Gmbh International | Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade |
US20220117623A1 (en) | 2020-10-15 | 2022-04-21 | Covidien Lp | Ultrasonic surgical instrument |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6325811B1 (en) * | 1999-10-05 | 2001-12-04 | Ethicon Endo-Surgery, Inc. | Blades with functional balance asymmetries for use with ultrasonic surgical instruments |
US20040078035A1 (en) * | 1999-01-25 | 2004-04-22 | Olympus Optical Co., Ltd. | Medical treatment instrument |
US20070088356A1 (en) * | 2003-11-19 | 2007-04-19 | Moses Michael C | Open vessel sealing instrument with cutting mechanism |
CN201379646Y (zh) * | 2009-03-12 | 2010-01-13 | 徐生源 | 腹腔镜手术用电凝剪 |
CN101686850A (zh) * | 2007-06-29 | 2010-03-31 | Kls马丁有限及两合公司 | 外科用器械 |
Family Cites Families (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4893530A (en) * | 1987-03-19 | 1990-01-16 | Warheit William A | Plier-type tool |
CA2065987A1 (en) * | 1991-04-19 | 1992-10-20 | Lutz Kothe | Surgical instrument |
US5258006A (en) * | 1992-08-21 | 1993-11-02 | Everest Medical Corporation | Bipolar electrosurgical forceps |
US5322055B1 (en) | 1993-01-27 | 1997-10-14 | Ultracision Inc | Clamp coagulator/cutting system for ultrasonic surgical instruments |
US5944737A (en) | 1997-10-10 | 1999-08-31 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having improved waveguide support member |
US5954736A (en) | 1997-10-10 | 1999-09-21 | Ethicon Endo-Surgery, Inc. | Coagulator apparatus having indexed rotational positioning |
US5873873A (en) | 1997-10-10 | 1999-02-23 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having improved clamp mechanism |
US6068647A (en) | 1997-10-10 | 2000-05-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having improved clamp arm tissue pad |
US5980510A (en) | 1997-10-10 | 1999-11-09 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having improved clamp arm pivot mount |
FR2820305B1 (fr) | 2001-02-06 | 2003-04-18 | Soprane Sa | Instrument chirurgical de type rongeur endoscopique |
US20070191713A1 (en) | 2005-10-14 | 2007-08-16 | Eichmann Stephen E | Ultrasonic device for cutting and coagulating |
EP2217157A2 (en) | 2007-10-05 | 2010-08-18 | Ethicon Endo-Surgery, Inc. | Ergonomic surgical instruments |
US8461744B2 (en) | 2009-07-15 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Rotating transducer mount for ultrasonic surgical instruments |
DE202009013504U1 (de) * | 2009-09-28 | 2010-01-14 | Aesculap Ag | Instrument für chirurgische Zwecke |
-
2012
- 2012-03-21 JP JP2014501204A patent/JP6067670B2/ja not_active Expired - Fee Related
- 2012-03-21 BR BR112013024523-9A patent/BR112013024523B1/pt not_active IP Right Cessation
- 2012-03-21 US US13/426,084 patent/US8974447B2/en active Active
- 2012-03-21 EP EP12712808.0A patent/EP2688496B8/en active Active
- 2012-03-21 CN CN201280025118.9A patent/CN103747752B/zh not_active Expired - Fee Related
- 2012-03-21 WO PCT/US2012/029924 patent/WO2012129292A2/en active Application Filing
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040078035A1 (en) * | 1999-01-25 | 2004-04-22 | Olympus Optical Co., Ltd. | Medical treatment instrument |
US6325811B1 (en) * | 1999-10-05 | 2001-12-04 | Ethicon Endo-Surgery, Inc. | Blades with functional balance asymmetries for use with ultrasonic surgical instruments |
US20070088356A1 (en) * | 2003-11-19 | 2007-04-19 | Moses Michael C | Open vessel sealing instrument with cutting mechanism |
CN101686850A (zh) * | 2007-06-29 | 2010-03-31 | Kls马丁有限及两合公司 | 外科用器械 |
CN201379646Y (zh) * | 2009-03-12 | 2010-01-13 | 徐生源 | 腹腔镜手术用电凝剪 |
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN106999240A (zh) * | 2015-04-30 | 2017-08-01 | 奥林巴斯株式会社 | 处置器具 |
CN106999240B (zh) * | 2015-04-30 | 2020-01-07 | 奥林巴斯株式会社 | 处置器具 |
CN108348271A (zh) * | 2015-10-19 | 2018-07-31 | 伊西康有限责任公司 | 具有双模式端部执行器和侧装夹持臂组件的外科器械 |
CN108348271B (zh) * | 2015-10-19 | 2021-07-20 | 伊西康有限责任公司 | 具有双模式端部执行器和侧装夹持臂组件的外科器械 |
Also Published As
Publication number | Publication date |
---|---|
BR112013024523B1 (pt) | 2021-04-27 |
CN103747752B (zh) | 2017-04-26 |
JP6067670B2 (ja) | 2017-01-25 |
WO2012129292A3 (en) | 2013-01-24 |
EP2688496A2 (en) | 2014-01-29 |
JP2014516270A (ja) | 2014-07-10 |
US8974447B2 (en) | 2015-03-10 |
US20120245582A1 (en) | 2012-09-27 |
EP2688496B1 (en) | 2019-07-24 |
WO2012129292A2 (en) | 2012-09-27 |
BR112013024523A2 (pt) | 2020-09-29 |
EP2688496B8 (en) | 2019-09-11 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN103747752A (zh) | 基于能量的剪刀装置 | |
US11426191B2 (en) | Ultrasonic surgical instruments with distally positioned jaw assemblies | |
US11266432B2 (en) | Ultrasonic surgical instrument | |
US10779845B2 (en) | Ultrasonic surgical instruments with distally positioned transducers | |
JP5642783B2 (ja) | 切断及び凝固のための超音波装置 | |
US6783524B2 (en) | Robotic surgical tool with ultrasound cauterizing and cutting instrument | |
CA2710251A1 (en) | Surgical instrument | |
JP2003502102A (ja) | 取り外し可能なクランプ・アームを有する超音波外科装置 | |
CN111867496A (zh) | 具有带超声刀的旋转端部执行器组件的外科装置和系统 | |
CN112292088A (zh) | 具有带超声刀的旋转端部执行器组件的外科装置和系统 |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
C06 | Publication | ||
PB01 | Publication | ||
C10 | Entry into substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
GR01 | Patent grant | ||
GR01 | Patent grant | ||
CF01 | Termination of patent right due to non-payment of annual fee | ||
CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20170426 |