CN109069172B

CN109069172B - Surgical forceps for treating and cutting tissue

Info

Publication number: CN109069172B
Application number: CN201680085376.4A
Authority: CN
Inventors: 丁伟江; 徐明峰
Original assignee: Covidien LP
Current assignee: Covidien LP
Priority date: 2016-05-05
Filing date: 2016-05-05
Publication date: 2021-09-24
Anticipated expiration: 2036-05-05
Also published as: WO2017190304A1; CN109069172A

Abstract

A forceps (10) includes a housing (20), a movable handle (30), a trigger (60), an outer shaft (90), an end effector assembly (100), and first and second drive rods (130, 140). The end effector assembly (100) disposed at the distal end of the outer shaft (90) includes first and second jaw members (112,122), at least one of which is pivotable between spaced-apart and approximated positions. The first and second drive rods (130,140) extend through the outer shaft (90) and operably couple the movable handle (30) and the trigger (60), respectively, to the end effector assembly (100). Actuation of the movable handle (30) translates the first drive rod (130) through the outer shaft (90) to pivot the first and/or second jaw members (112,122) from the spaced-apart position to the approximated position. Actuation of the trigger (60) translates the second drive rod (140) through the outer shaft (90) to translate the first jaw member (112) relative to the outer shaft (90) and the second jaw member (122) from a grasping position to a cutting position.

Description

Surgical forceps for treating and cutting tissue

Background

Technical Field

The present disclosure relates generally to surgical instruments and, more particularly, to surgical clips for grasping tissue, treating the grasped tissue with energy, and cutting the grasped and/or treated tissue.

Background of the related art

A surgical clamp is a forceps-like instrument that relies on mechanical action between its jaw members to grasp, clamp and contract tissue. Energy-based surgical clamps utilize both mechanical clamping action and energy (e.g., Radio Frequency (RF) energy, microwave energy, ultrasonic energy, optical energy, thermal energy, etc.) to heat tissue to treat (e.g., coagulate, cauterize, or seal) the tissue. Often, once the tissue is treated, the surgeon must accurately sever the treated tissue. Accordingly, many surgical clips are designed to incorporate a knife or cutting member for effectively severing the treated tissue.

Disclosure of Invention

As used herein, the term "distal" refers to the portion being described that is distal from the user, while the term "proximal" refers to the portion being described that is proximal to the user. Further, to the extent consistent, any aspect described herein may be used in combination with any of the other aspects described herein.

According to the present disclosure, there is provided a clamp, comprising: a housing; an outer shaft extending distally from the housing; a movable handle operably coupled to the housing; a trigger operably coupled to the housing; an end effector assembly disposed at the distal end of the outer shaft; and first and second drive rods extending through the outer shaft. The end effector assembly includes first and second jaw members, at least one of which is pivotable relative to the other and the outer shaft between a spaced-apart position and an approximated position. The first jaw member is translatable relative to the outer shaft and the second jaw member between a grasping position and a cutting position, while the second jaw member is prevented from translating relative to the outer shaft and the first jaw member. The first drive rod is operably coupled between the movable handle and the first and second jaw members such that actuation of the movable handle translates the first drive rod through the outer shaft to pivot the first and/or second jaw members from the spaced-apart position to the approximated position. The second drive rod is operably coupled between the trigger and the first and second jaw members such that actuation of the trigger translates the second drive rod through the outer shaft to translate the first jaw member from the grasping position to the cutting position.

In one aspect of the present disclosure, each of the first and second jaw members includes a proximal flange and a distal jaw body. The proximal flange is operably coupled to the first and second drive bars.

In another aspect of the present disclosure, the distal jaw bodies define a curved configuration such that the distal jaw bodies are misaligned with one another as the first jaw member translates from the grasping position to the cutting position.

In yet another aspect of the present disclosure, the distal jaw body defines a stepped tissue contacting portion such that the stepped tissue contacting portions move in a shearing action relative to each other as the first jaw member translates from the grasping position to the cutting position.

In yet another aspect of the present disclosure, each of the first and second jaw members defines a cam slot through a proximal flange thereof. The first drive bar supports a first drive pin configured to translate through the cam slot to pivot the first and/or second jaw members between the spaced-apart and approximated positions.

In yet another aspect of the present disclosure, the first jaw member defines a pivot aperture, the second jaw member defines a pivot slot, and the second drive bar supports a second drive pin configured to be received within the pivot aperture and the pivot slot such that translation of the second drive pin translates the first jaw member between the gripping position and the cutting position and such that translation of the second drive pin moves the second drive pin through the pivot slot.

In another aspect of the disclosure, the second drive pin defines a first height in the first orientation and a second height in the second orientation. The pivot slot includes a first portion and a second portion defining a height less than the first height and greater than the second height such that when the second drive pin is disposed in the first orientation, movement of the second drive pin into the second portion of the pivot slot is prevented, and when the second drive pin is disposed in the second orientation, movement of the second drive pin into the second portion of the pivot slot is permitted. In such aspects, the first orientation of the second drive pin may correspond to the spaced-apart position of the first and second jaw members such that when the first and second jaw members are disposed in the spaced-apart position, the first jaw member is prevented from translating to the cutting position.

In another aspect of the present disclosure, the first and second drive shafts extend through the outer shaft adjacent to each other.

In yet another aspect of the present disclosure, the first jaw member and/or the second jaw member is adapted to be connected to an energy source.

In yet another aspect of the present disclosure, distal translation of the first drive rod through the outer shaft pivots the first and/or second jaw members from the spaced-apart position to the approximated position. Additionally or alternatively, proximal translation of the second drive rod through the outer shaft translates the first jaw member from the grasping position to the cutting position.

According to an aspect of the present disclosure, there is provided another clamp, comprising: an outer shaft; an end effector assembly disposed at the distal end of the outer shaft; first and second drive rods extending through the outer shaft; and a first drive pin and a second drive pin. The end effector assembly includes first and second jaw members each including a proximal flange and a distal body. The proximal flange of the first jaw member defines a pivot aperture and a cam slot, and the proximal flange of the second jaw member defines a pivot slot and a cam slot. The first drive pin is supported toward the distal end of the first drive bar and extends through the cam slot such that translation of the first drive bar through the outer shaft moves the first drive pin through the cam slot to pivot the first and/or second jaw members between spaced-apart and approximated positions relative to the outer shaft and the other of the first and/or second jaw members. The second drive pin is supported toward the distal end of the second drive shaft and extends through the pivot aperture and the pivot slot such that translation of the second drive rod through the outer shaft moves the second drive pin through the pivot slot and translates the first jaw member relative to the outer shaft and the second jaw member between a grasping position and a cutting position.

In one aspect of the present disclosure, the distal jaw body defines a curved configuration such that the distal jaw bodies are misaligned with one another as the first jaw member translates from the grasping position to the cutting position. In addition, the distal jaw body can define a stepped tissue contacting portion such that the stepped tissue contacting portions move in a shearing action relative to each other as the first jaw member translates from the grasping position to the cutting position.

In another aspect of the disclosure, the second drive pin defines a first height in the first orientation and a second height in the second orientation, and the pivot slot includes a first portion and a second portion. The second portion of the pivot slot defines a height less than the first height and greater than the second height such that when the second drive pin is disposed in the first orientation, movement of the second drive pin into the second portion of the pivot slot is prevented, and when the second drive pin is disposed in the second orientation, movement of the second drive pin into the second portion of the pivot slot is permitted. The first orientation may correspond to the spaced-apart position of the first and second jaw members, thus preventing the first jaw member from translating to the cutting position when disposed in the spaced-apart position.

In yet another aspect of the present disclosure, the first and second drive shafts extend through the outer shaft adjacent to each other.

Drawings

Various aspects and features of the disclosure are described below in conjunction with the following figures, where like numerals identify similar or identical elements:

FIG. 1 is a perspective view of an endoscopic surgical clamp provided in accordance with the present disclosure;

FIG. 2A is an exploded perspective view of the clamp of FIG. 1;

FIG. 2B is a side view of the pliers of FIG. 1 with a portion of the housing removed to show internal components therein;

FIG. 3A is a perspective view of the distal end of the clamp of FIG. 1 with the outer shaft removed to show internal components therein;

FIG. 3B is an exploded perspective view of the distal end of the clamp of FIG. 1 with the outer shaft removed;

FIG. 4A is a perspective view of a first jaw member of an end effector assembly of the forceps of FIG. 1;

FIG. 4B is a perspective view of a second jaw member of the end effector assembly of the forceps of FIG. 1;

FIG. 5A is a side view of the distal end of the jaws of FIG. 1 with the outer shaft removed and the end effector assembly disposed in a spaced-apart position;

FIG. 5B is a side view of the distal end of the jaws of FIG. 1 with the outer shaft removed and the end effector assembly disposed in an approximated position;

FIG. 5C is a side view of the distal end of the jaws of FIG. 1 with the outer shaft removed and the end effector assembly disposed in a cutting position;

FIG. 6A is a perspective partial cross-sectional view of the distal end of the clip of FIG. 1 with the end effector assembly disposed in an approximated position grasping tissue therebetween for treating the grasped tissue; and is

FIG. 6B is a perspective partial cross-sectional view of the distal end of the jaws of FIG. 1 with the end effector assembly disposed in a cutting position having separated the grasped tissue.

Detailed Description

Turning to fig. 1-6B, an endoscopic surgical clamp provided in accordance with the present disclosure is indicated generally by the reference numeral 10. As described in greater detail below, the forceps 10 are configured to facilitate grasping tissue, treating the grasped tissue with energy, and cutting the grasped and/or treated tissue. Although described in detail herein with respect to forceps 10, aspects and features of the present disclosure are equally applicable to any suitable surgical instrument.

Referring to fig. 1-2B, forceps 10 generally includes a housing 20 formed of a first housing portion 22a and a second housing portion 22B, a handle assembly 30, a trigger assembly 60, an activation button 70, an outer shaft 90, an end effector assembly 100, first and second drive assemblies 130,140, and a rotation assembly 150.

The housing portions 22a, 22b of the housing 20 are substantially similar to each other and each include a distal aperture portion 23, a rotary wheel window 24, a trigger pivot 25, a movable handle pivot 26, a plurality of engagement members 27, a button compartment portion 28, and a cable aperture portion 29. Distal orifice portion 23 (only distal orifice portion 23 of housing portion 22a is shown) cooperates to define a distal orifice through which outer shaft 90 can extend.

The rotator wheel window 24 enables a rotator wheel 152 of the rotator assembly 150 to extend therethrough to enable manipulation thereof by a user.

The trigger pivot 25 (only the trigger pivot 25 of the housing portion 22a is shown) is configured to pivotally support the trigger 62 of the trigger assembly 60 therebetween such that the trigger 62 is pivotable relative to the housing 20.

The movable handle pivot 26 (only the movable handle pivot 26 of the housing portion 22a is shown) is configured to pivotably support the movable handle 32 therebetween to enable the movable handle 32 to pivot relative to the housing 20.

The engagement members 27 enable the first and second housing portions 22a, 22b to engage with one another to form the housing 20 (e.g., via pin-hole engagement, screws, etc.), although other suitable engagements (e.g., ultrasonic welding) are also contemplated.

The button compartment portions 28 (only the button compartment portion 28 of the housing portion 22a is shown) cooperate to define a button compartment for receiving the activation button 70.

The cable port portion 29 (only the cable port portion 29 of the housing portion 22a is shown) cooperates to define a cable port for receiving an electrosurgical cable (not shown) therethrough. The electrosurgical cable includes electrical wires (not shown) extending therethrough to operably couple an energy source (e.g., an electrosurgical generator (not shown)) to the activation button 70 and the end effector assembly 100 so as to be configured to selectively supply energy to the end effector assembly 100 in response to actuation of the activation button 70. Alternatively, the forceps 10 may be configured as a handheld device including a battery and generator component disposed on or within the housing 20.

The handle assembly 30 includes a movable handle 32, a first link 42, and a second link 46. The movable handle 32 includes: a grip portion 34 extending from the housing 20 and defining a finger hole 36 to facilitate gripping by a user; an extension portion 38 extending from the grip portion 34 into the housing 20; and a protrusion 40 protruding from the grip portion 34 toward the activation button 70 to facilitate actuation of the activation button 70 in response to actuation of the movable handle 32.

The first link 42 is fixed relative to and extends from the extension portion 38 of the movable handle 32 at a joint 43. The junction point 43 further defines a pair of outwardly facing pivot apertures (only one of which is shown) configured to receive the movable handle pivot 26 of the housing portions 22a, 22b to pivotably couple the movable handle 32 relative to the housing 20. As such, the movable handle 32 is pivotable relative to the housing 20 between an initial position, in which the movable handle 32 is spaced apart from the fixed handle portion 50 of the housing 20, and an actuated position, in which the movable handle 32 is disposed proximate the fixed handle portion 50. The protrusion 40 of the movable handle 32 may be configured to actuate the activation button 70 in an actuated position of the movable handle 32, or it may be desirable to move the movable handle 32 to a second actuated position in which the movable handle 32 is disposed closer to the fixed handle portion 50 such that the protrusion 40 actuates the activation button 70.

The second link 46 defines a bifurcated configuration (only one arm of which is shown) and is pivotably coupled to the first link 42 at a first end of the second link 46 via a floating pivot 47. The second link 46 further includes a drive pin 49 disposed at a second end thereof, the drive pin 49 configured for receipt within the first spindle 134 of the first drive assembly 130 such that pivoting of the movable handle 32 between the initial and actuated positions translates the first drive rod 132 of the first drive assembly 130 through the housing 20 and the outer shaft 90 and relative to the housing 20 and the outer shaft 90.

The trigger assembly 60 includes: a trigger 62 defining a toggle portion 64 extending from the housing 20 to facilitate user manipulation; a pivot portion 66 disposed within the housing 20; and a drive portion 68 extending between the toggle portion 64 and the pivot portion 66. The pivot portion 66 defines a pair of outwardly facing pivot apertures (only one of which is shown) configured to receive the trigger pivots 25 of the housing portions 22a, 22b to pivotably couple the trigger 62 relative to the housing 20. In this way, the trigger 62 is pivotable relative to the housing 20 between a first more distal position and a second more proximal position.

The drive portion 68 of the trigger 62 defines an opening 69a and a pair of opposed drive pin portions 69b extending inwardly into the opening 69 a. As described in detail below, the drive pin portion 69b is configured for receipt within the second spindle 144 of the second drive assembly 140 such that pivoting of the trigger 62 between the first and second positions translates the second drive rod 142 of the second drive assembly 140 through the housing 20 and the outer shaft 90 and relative to the housing 20 and the outer shaft 90.

Still referring to fig. 1-2B, the outer shaft 90 includes a ring 92 engaged around it toward its proximal end. The ring 92 is configured for receipt within an annular recess 93 defined within each housing portion 22a, 22b (only the annular recess 93 of housing portion 22a is shown) to longitudinally fix the outer shaft 90 relative to the housing 20 while allowing the outer shaft 90 to rotate relative to the housing 20. The outer shaft 90 also defines a pair of opposed apertures 94 (only one of which is shown) and a pair of opposed longitudinally extending slots 96 (only one of which is shown). As described below, aperture 94 and slot 96 facilitate operable coupling of end effector assembly 100 at the distal end of outer shaft 90.

Turning to fig. 3A-4B, in conjunction with fig. 2A and 2B, end effector assembly 100 includes first and

second jaw members

110 and 120 that are pivotably coupled to one another and to outer shaft 90 such that first and

second jaw members

110 and 120 are movable relative to one another and outer shaft 90 between a spaced-apart position and an approximated position for grasping tissue therebetween. As an alternative to this two-sided configuration, end effector assembly 100 can define a single-sided configuration, e.g., wherein jaw member 120 is fixed relative to outer shaft 90 and jaw member 110 can be pivoted relative to jaw member 120 and outer shaft 90 between a spaced-apart position and an approximated position.

Each

jaw member

110, 120 of end effector assembly 100 includes a

proximal flange

111, 121 and a

distal jaw body

112, 122. Proximal flange 111 of jaw member 110 defines a cam slot 113, which cam slot 113 has proximal and

distal slot portions

114a and 114b, respectively. Distal slot portion 114b extends generally longitudinally along proximal flange 111 of jaw member 110, although distal slot portion 114b can be angled relative to the longitudinal axis of proximal flange 111. Proximal slot portion 114a is angled relative to distal slot portion 114b (in embodiments where distal slot portion 114b is angled, the angle is greater than the angle of distal slot portion 114 b) and relative to the longitudinal axis of proximal flange 111 of jaw member 110. Proximal flange 111 of jaw member 110 further defines a first pivot aperture 115 therethrough, first pivot aperture 115 being disposed proximal of cam slot 113.

Proximal flange 121 of jaw member 120 defines a bifurcated configuration formed by a pair of spaced apart flange sections configured to receive proximal flange 111 of jaw member 110 therebetween. Alternatively, proximal flange 111 of jaw member 110 can be bifurcated and configured to receive a single proximal flange 121 of jaw member 120, the two

proximal flanges

111, 121 can be single and arranged in a side-by-side relationship, or the two

proximal flanges

111, 121 can be bifurcated and arranged in an offset or nested configuration. Since the two flange sections of the proximal flange 121 are similar, the flange sections will be collectively referred to hereinafter as the proximal flange 121 unless otherwise noted.

Proximal flange portion 121 of jaw member 120 defines a cam slot 123, a first pivot aperture 124a disposed proximal of cam slot 123, and a second pivot aperture 125 positioned generally between cam slot 123 and first pivot aperture 124 a. Cam slot 123 defines a generally linear (although an arcuate configuration is also contemplated) and is angled relative to the longitudinal axis of proximal flange 121 of jaw member 120 in an opposite direction relative to the angle of proximal slot portion 114a of cam slot 113 of proximal flange 111 of jaw member 110. The first drive pin 103 is configured for slidable positioning within the opposing longitudinally extending slots 96 of the outer shaft 90, the cam slot 113 of the proximal flange 111 of the jaw member 110, and the cam slot 123 of the proximal flange 121 of the jaw member 120. As detailed below, first drive pin 103 is further configured to be operably coupled to a first drive rod 132 of first drive assembly 130 such that translation of first drive rod 132 through outer shaft 90 (e.g., in response to pivoting of movable handle 32 (fig. 1)) pivots

jaw members

110, 120 relative to one another between a spaced-apart position and an approximated position (fig. 5B) (fig. 5A).

First pivot aperture 124a of proximal flange 121 of jaw member 120 includes a tail slot 124b communicating therewith and extending proximally therefrom longitudinally relative to the longitudinal axis of proximal flange 121 of jaw member 120. The tail slot 124b defines a reduced height compared to the diameter of the first pivot aperture 124 a. Second drive pin 105 is configured to be received within pivot aperture 115 of proximal flange 111 of jaw member 110 and first pivot aperture 124a of proximal flange 121 of jaw member 120 to pivotably

couple jaw members

110, 120 relative to one another. The second drive pin 105 is also captured, rotatably secured within a pair of recesses 143, the recesses 143 being defined at the distal end of the second drive bar 142 of the second drive assembly 140. As a result of this configuration, proximal translation of second drive bar 142 moves second drive pin 105 proximally from first pivot aperture 124a into tail slot 124b, thereby allowing jaw member 120 to remain stationary upon proximal translation of second drive bar 142. However, with respect to jaw member 110, wherein second drive pin 105 extends through pivot aperture 115 of proximal flange 111 of jaw member 110, proximal translation of second drive bar 142 pulls jaw member 110 to slide proximally to a cutting position with respect to jaw member 120.

Second drive pin 105 is configured to block

jaw members

110, 120 from entering tail slot 124b when disposed in the spaced-apart position, thereby blocking jaw member 110 from moving to the cutting position when

jaw members

110, 120 are disposed in the spaced-apart position. Second drive pin 105 defines a central portion 106a, which central portion 106a is configured for receipt within pivot aperture 115 of proximal flange 111 of jaw member 110 and a pair of opposing outer portions 106b, each of which is configured for receipt within first pivot aperture 124a of one of the flange segments of proximal flange 121 of jaw member 120. Central portion 106a defines a circular cross-sectional configuration such that rotation of jaw member 110 about central portion 106a of second drive pin 105 is not prevented by second drive pin 105 regardless of its orientation. The outer portion 106b defines a semi-circular configuration such that in a first orientation, e.g., with the semi-circle facing proximally or distally, the outer portion 106b defines a height equal to the entire diameter of the second drive pin 105, and in a second orientation, e.g., with the semi-circle facing upwardly or downwardly, the outer portion 106b defines a height equal to the half diameter of the second drive pin 105. At an intermediate orientation between the first and second orientations, the height of the outer portion 106b decreases from a full diameter to a half diameter. The tail slot 124b defines a height that is slightly larger than a half diameter of the second drive pin 105 and smaller than a full diameter of the second drive pin 105.

In the approximated position of

jaw members

110, 120, proximal flange 121 of jaw member 120 is oriented such that tail slot 124b is highly aligned with the half diameter of second drive pin 105, thereby allowing second drive pin 105 to translate therethrough. However, when

jaw members

110, 120 are not in or sufficiently approximate to the approximated position, tail slot 124b of proximal flange 121 of jaw member 120 is aligned with the height of second drive pin 105 (the height of second drive pin 105 is greater than the height of tail slot 124 b), thereby preventing translation of second drive pin 105 therethrough. The particular height of tail slot 124b relative to the diameter of second drive pin 105 at which jaw member 110 is allowed to move to the cutting position may be selected based on the desired position of

jaw members

110, 120. This may correspond to, for example, an approximated position or a position sufficiently similar to an approximated position, e.g., to enable jaw member 110 to move to a cutting position in which a larger tissue structure is grasped between

jaw members

110, 120, thereby preventing

jaw members

110, 120 from reaching the approximated position.

A pair of pivot pin members (not expressly shown) are configured for receipt within second pivot apertures 125 of the flange section of proximal flange 121 of jaw member 120 and opposing apertures 94 (see fig. 1) of outer shaft 90 to pivotally couple jaw member 120 to outer shaft 90 on either side of proximal flange 111 of jaw member 110. This configuration prevents translation of jaw member 120. Thus, jaw member 120 can only be pivotally moved relative to outer shaft 90.

With continued reference to fig. 3A-4B, in conjunction with fig. 2A and 2B, distal jaw bodies 112,122 of

jaw members

110, 120 each define a curved configuration in which distal end jaw bodies 112,122 are bent laterally in a similar direction. Distal jaw bodies 112,122 each further define opposing

tissue contacting portions

116, 126. Tissue contacting portion 116 of distal jaw body 112 of jaw member 110 is defined by a protruding tissue contacting surface 117a and a recessed tissue contacting surface 117b offset by step 117 c. Likewise, tissue contacting portion 126 of distal jaw body 122 of jaw member 120 is defined by a protruding tissue contacting surface 127a and a recessed tissue contacting surface 127b offset by a step 127 c.

Tissue contacting portions

116, 126 define complementary configurations such that when

jaw members

110, 120 are disposed in the approximated position, steps 117c, 127c thereof interfit with one another (see fig. 6A), e.g., with protruding surface 117a of jaw member 120 opposing recessed surface 127b of jaw member 120 and recessed surface 117b of jaw member 110 opposing protruding surface 127a of jaw member 120. As described in detail below, due to the curved, stepped configuration of

tissue contacting portions

116, 126 of

jaw members

110, 120, proximal sliding of jaw member 110 to the cutting position causes

tissue contacting portions

116, 126 to move at least partially out of the interfitting position to the stacked configuration, wherein in a shearing action, steps 117c, 127c slide laterally past each other to cut tissue disposed therebetween.

The

tissue contacting portions

116, 126 are formed at least in part of an electrically conductive material, and one or both are adapted to be connected to an energy source and the activation button 70 (fig. 1) so as to be selectively energizable thereto for treating tissue grasped therebetween. In some embodiments, one or both of distal jaw bodies 112,122 of

jaw members

110, 120 includes an outer

insulative jaw housing

118, 128. Alternatively, one or both of distal jaw bodies 112,122 can be formed entirely of an electrically conductive material.

Referring to fig. 2A-3B, first drive assembly 130 includes a first drive rod 132 that extends from housing 20 through outer shaft 90 to end effector assembly 100. As described above, the first drive rod 132 supports the first drive pin 103 at the distal end thereof. As mentioned above, first drive pin 103 operably couples first drive rod 132 with

jaw members

110, 120 such that translation of first drive rod 132 through outer shaft 90 (e.g., in response to pivoting of movable handle 32 (fig. 1)) pivots

jaw members

The first spindle 134 of the drive assembly 130 is slidably disposed about the first drive rod 132 toward the proximal end thereof. The drive pins 49 of the handle assembly 30 are configured for receipt within an annular recess defined by the first spindle 134 such that pivoting of the movable handle 32 between the initial and actuated positions translates the spindle 134 relative to the housing 20. A first biasing member 136 is disposed about the first drive rod 132 and is engaged between the first mandrel 134 and a proximal washer 138, the proximal washer 138 being fixedly engaged about the first drive rod 132, such as via welding or pin aperture engagement. This configuration establishes a force limiting mechanism whereby first biasing member 136 resists extension up to a threshold force such that, below the threshold force, pivoting of movable handle 32 from the initial position toward the actuated position pushes first mandrel 134 and first drive bar 132 distally to thereby move

jaw members

110, 120 from the spaced-apart position toward the approximated position. However, upon reaching the threshold force, corresponding to a threshold pressure applied to tissue grasped between

jaw members

110, 120, further pivoting of movable handle 32 from the initial position toward the actuated position pushes first mandrel 134 distally and causes first biasing member 136 to elongate such that first drive bar 132 remains in place, thereby maintaining the position and pressure applied by

jaw members

110, 120. First drive assembly 130 further includes a second biasing member 139 operably positioned to bias first drive bar 132 proximally, thereby biasing

jaw members

110, 120 toward the spaced-apart position and movable handle 32 toward the initial position.

Second drive assembly 140 includes a second drive rod 142 that extends from housing 20 through outer shaft 90 to end effector assembly 100. A second drive rod 142 extends within outer shaft 90 adjacent first drive rod 132. The second drive bar 142 supports the second drive pin 105 within its recess 143 to thereby operably couple the second drive bar 142 to the

jaw members

110, 120. As such, translation of second drive rod 142 through outer shaft 90 (e.g., in response to pivoting of trigger 62) slides jaw member 110 relative to jaw member 120 between a grasping position (fig. 5A and 5B) and a cutting position (fig. 5C).

Second drive assembly 140 includes a second spindle 144, which second spindle 144 is slidably disposed about first drive rod 132 of first drive assembly 130 and fixedly coupled toward its proximal end to second drive rod 142 of second drive assembly 140, e.g., via welding or pin-and-socket engagement. Second spindle 144 is configured to receive drive pin portion 69B of trigger assembly 60 within an annular recess defined by second spindle 144 such that pivoting of trigger 62 between the first and second positions pushes second spindle 144 proximally, thereby translating second drive bar 142 proximally to slide jaw member 110 from the grasping position (fig. 5A and 5B) to the cutting position (fig. 5C).

With particular reference to fig. 3B, a control block 146 is operably coupled to the first and

second drive rods

132, 142, respectively, to limit relative movement of the first and

second drive rods

132, 142, respectively, to longitudinal translation. The control block 146 extends through a first slot 147 defined in the first drive rod 132 and a second slot 148 defined in the second drive rod 142. The length of first slot 147 is generally similar to the length of control block 146 to establish a secure engagement therebetween. Second slot 148 is elongated relative to the length of control block 146 to allow control block 146 to translate along second slot 148 as first drive rod 132 translates relative to second drive rod 142, and vice versa.

Referring again to fig. 2A and 2B, the rotation assembly 150 includes a rotation wheel 152 fixedly mounted on the outer shaft 90 within the housing 20. The rotator wheel 152 extends through the rotator wheel window 24 of the housing 20 to enable manipulation of the rotator wheel 152 from outside the housing 20. With rotation wheel 152 fixed about outer shaft 90, outer shaft 90 coupled to

jaw members

110, 120, and

jaw members

110, 120 coupled to first and second drive bars 142, rotation of rotation wheel 152 relative to housing 20 thereby rotates outer shaft 90, end effector assembly 100, and first and second drive assemblies 130,140, respectively, relative to housing 20.

Turning now to fig. 1 and 5A-6B, the use and operation of the pliers 10 is described in detail. Initially, movable handle 32 is disposed in an initial position and, thus,

jaw members

110, 120 are disposed in a spaced apart position (fig. 5A). In this position, as shown in fig. 5A, first drive lever 132 is disposed in a proximal-most position and second drive lever 142 is disposed in a distal-most position. Further, in this position, the first drive pin 103 is disposed toward the proximal end of the slots 113, 123 (fig. 4A and 4B), and the second drive pin 105 is disposed within the first pivot aperture 124A of the proximal flange 121 of the jaw member 120 (fig. 4A and 4B).

With

jaw members

110, 120 disposed in a spaced-apart position, clip 10 can be manipulated and/or manipulated into position such that tissue to be grasped, treated, and/or cut is disposed between

jaw members

110, 120. This may include rotating rotation wheel 152 to rotate

jaw members

110, 120 to a desired orientation. Once

jaw members

110, 120 are properly positioned, and to grasp tissue, movable handle 32 is moved from the initial position to the actuated position. Movement of movable handle 32 to the actuated position distally translates first drive bar 132 such that first drive pin 132 moves distally through slots 113, 123 (fig. 4A and 4B) to thereby pivot

jaw members

110, 120 from the spaced-apart position toward the approximated position (fig. 5B and 6A). At this point, second drive bar 142 remains stationary and second drive pin 105 remains disposed within first pivot aperture 124A of proximal flange 121 of jaw member 120 (fig. 4A and 4B).

With

jaw members

110, 120 disposed in the approximated position (fig. 6A) between which tissue "T" is grasped, energy may be supplied to either or both of

tissue contacting portions

116, 126 of

jaw members

110, 120 to treat tissue "T". More specifically, the tab 40 of the handle assembly 30 can be configured to activate the activation button 70 when the

jaw members

110, 120 reach the approximated position, or the movable handle 32 can be moved further from the actuated position toward the stationary handle 50 to activate the activation button 70. In either configuration, energy is conducted through the tissue "T" to treat the tissue "T".

Once the tissue "T" has been treated, or in the event that only cutting of the tissue "T" is desired, the trigger 62 is moved from the first position to the second position to thereby translate the second drive rod 142 proximally. Proximal translation of second drive bar 142 pulls second drive pin 105 proximally, thereby also pulling first jaw member 110 proximally from the grasping position (fig. 5B and 6A) to the cutting position (fig. 5C and 6B). As second drive pin 105 moves proximally, second drive pin 105 enters proximal tail 124B of proximal flange 121 of jaw member 120 (fig. 4A and 4B), thus allowing jaw member 120 to remain stationary during proximal movement of jaw member 110 to the cutting position (fig. 5C and 6B).

Referring to fig. 6A and 6B, due to the curved configuration of distal jaw bodies 112,122 of jaw members 110, 120 (fig. 4A and 4B, respectively), as noted above, as jaw member 110 is translated proximally relative to jaw member 120,

tissue contacting portions

116, 126 are moved at least partially from the interfitting position to the stacked configuration, wherein

steps

117c, 127c slide laterally past each other to cut tissue "T" (fig. 6B) disposed therebetween in a shearing action. The

steps

117c, 127c may define sharpened edges to facilitate cutting in this manner. Further, in embodiments where the distal slot portion 114b of jaw member 110 is angled, the angled configuration facilitates sliding of

steps

117c, 127c over one another by slightly lifting jaw member 110 (due to the interaction between first drive pin 103 and angled distal slot portion 114 b) when jaw member 110 is pulled proximally.

Once the tissue "T" has been grasped, treated and/or cut, the trigger 62 may return to the first position and thereafter the movable handle 32 returns to the initial position to release the tissue "T". The clip 10 can then be used to grasp, manipulate and/or cut other tissue, similar to that detailed above.

The various embodiments disclosed herein may also be configured to work with robotic surgical systems and are commonly referred to as "telesurgery". Such systems employ various robotic elements to assist the surgeon in the operating room and allow for remote operation (or partial remote operation) of the surgical instrument. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be used for this purpose, and robotic surgical systems may be designed to assist the surgeon during the procedure or treatment procedure. Such robotic systems may include remotely steerable systems, automated flexible surgical systems, remote articulating surgical systems, wireless surgical systems, modular or selectively configurable teleoperated surgical systems, and the like.

In particular, the transmission assembly of the present disclosure may be configured for use with such robotic systems, in addition to use with manually operated assemblies. That is, the transmission assembly may be coupled to a manually operated assembly or a robotic system, according to certain protocols. Thus, the transmission assembly of the present disclosure can be used in either configuration without requiring multiple transmission assemblies, depending on whether robotic or manual surgery is desired.

With respect to coupling the drive assembly to the robotic system, the robotic system will include suitable components, such as those detailed above, that are capable of manipulating and actuating the drive assembly. The robotic surgical system may also be used with one or more consoles near the operating room or at remote locations. In this case, one set of surgeons or nurses may prepare the patient for the surgical procedure and construct the robotic surgical system using one or more drive assemblies, while another surgeon (or set of surgeons) remotely controls the drive assemblies via the robotic surgical system. It should be appreciated that a highly skilled surgeon may perform multiple operations at multiple locations without having to leave his/her remote console, which is economically advantageous and advantageous for a patient or series of patients.

In use, the robotic arms of the surgical system are typically coupled to a pair of main handles by a controller. The handle may be moved by the surgeon to produce corresponding movement, manipulation, and/or actuation of a drive assembly coupled thereto. The movement of the main handle may be scaled such that the operable components of the transmission assembly have corresponding movements that are different, smaller, or larger than the movements performed by the hand operated by the surgeon. The zoom factor or gear ratio may be user adjustable so that an operator may control the resolution of the operable components of the gearing assembly.

The main handle of the robotic system may also include various sensors to provide feedback to the surgeon regarding various tissue parameters or conditions, such as tissue resistance due to manipulation, cutting or otherwise treating, pressure of the instrument on the tissue, tissue temperature, tissue impedance, and the like. It will be appreciated that such sensors provide enhanced tactile feedback to the surgeon that simulates actual operating conditions. The main handle may also include a variety of different actuators for delicate tissue manipulation or treatment, further enhancing the surgeon's ability to mimic actual operating conditions.

From the foregoing and with reference to the various figures, those skilled in the art will appreciate that certain modifications may also be made to the disclosure without departing from the scope thereof. While several embodiments of the disclosure have been illustrated in the accompanying drawings, the disclosure is not intended to be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Accordingly, the foregoing description is not to be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

Claims

1. A clamp, comprising:

a housing;

an outer shaft extending distally from the housing;

a movable handle operably coupled to the housing;

a trigger operably coupled to the housing;

an end effector assembly disposed at the distal end of the outer shaft, the end effector assembly comprising a first jaw member and a second jaw member, at least one of the first and second jaw members being pivotable relative to the other and the outer shaft between a spaced-apart position and an approximated position, the first jaw member being translatable relative to the outer shaft and the second jaw member between a grasping position and a cutting position, the second jaw member being prevented from translating relative to the outer shaft and the first jaw member;

a first drive rod extending through the outer shaft and operably coupled between the movable handle and the first and second jaw members such that actuation of the movable handle translates the first drive rod through the outer shaft to pivot at least one of the first or second jaw members from the spaced-apart position to the approximated position; and

a second drive rod extending through the outer shaft and operably coupled between the trigger and the first and second jaw members such that actuation of the trigger translates the second drive rod through the outer shaft to translate the first jaw member from the grasping position to the cutting position.

2. The forceps of claim 1, wherein each of the first and second jaw members includes a proximal flange and a distal jaw body, the proximal flange being operably coupled to the first and second drive bars.

3. The forceps of claim 2, wherein the distal jaw bodies define a curved configuration such that the distal jaw bodies are misaligned with one another as the first jaw member translates from the grasping position to the cutting position.

4. The forceps of claim 3, wherein the distal jaw body defines a stepped tissue contacting portion such that the stepped tissue contacting portions move in a shearing action relative to one another as the first jaw member translates from the grasping position to the cutting position.

5. The forceps according to claim 2, wherein each of the first and second jaw members defines a cam slot therethrough the proximal flange thereof, and wherein the first drive bar supports a first drive pin configured for translation through the cam slot to pivot at least one of the first or second jaw members between the spaced-apart and approximated positions.

6. The forceps of claim 2, wherein the first jaw member defines a pivot aperture, the second jaw member defines a pivot slot, and the second drive bar supports a second drive pin configured to be received within the pivot aperture and the pivot slot such that translation of the second drive pin translates the first jaw member between the gripping position and the cutting position, and such that translation of the second drive pin moves the second drive pin through the pivot slot.

7. The clamp of claim 6, wherein the second drive pin defines a first height in a first orientation and a second height in a second orientation, and wherein the pivot slot includes a first portion and a second portion defining a height that is less than the first height and greater than the second height, such that when the second drive pin is disposed in the first orientation, movement of the second drive pin into the second portion of the pivot slot is prevented, and when the second drive pin is disposed in the second orientation, movement of the second drive pin into the second portion of the pivot slot is permitted.

8. The forceps of claim 7, wherein the first orientation of the second drive pin corresponds to the spaced-apart position of the first and second jaw members such that when the first and second jaw members are disposed in the spaced-apart position, the first jaw member is prevented from translating to the cutting position.

9. The forceps of claim 1, wherein the first and second drive shafts extend through the outer shaft adjacent to one another.

10. The forceps of claim 1, wherein at least one of the first or second jaw members is adapted to be connected to an energy source.

11. The forceps of claim 1, wherein distal translation of the first drive rod through the outer shaft pivots at least one of the first or second jaw members from the spaced-apart position to the approximated position.

12. The forceps of claim 1, wherein proximal translation of the second drive rod through the outer shaft translates the first jaw member from the grasping position to the cutting position.

13. A clamp, comprising:

an outer shaft;

an end effector assembly disposed at a distal end of the outer shaft, the end effector assembly comprising first and second jaw members, each of the first and second jaw members comprising a proximal flange and a distal jaw body, the proximal flange of the first jaw member defining a pivot aperture and a cam slot, the proximal flange of the second jaw member defining a pivot slot and a cam slot;

a first drive rod extending through the outer shaft;

a first drive pin supported toward a distal end of the first drive rod and extending through the cam slot such that translation of the first drive rod through the outer shaft moves the first drive pin through the cam slot to pivot at least one of the first or second jaw members between a spaced-apart position and an approximated position relative to the outer shaft and the other of the first or second jaw members;

a second drive rod extending through the outer shaft; and

a second drive pin supported toward the distal end of the second drive shaft and extending through the pivot aperture and the pivot slot such that translation of the second drive rod through the outer shaft moves the second drive pin through the pivot slot and translates the first jaw member relative to the outer shaft and the second jaw member between a grasping position and a cutting position.

14. The forceps of claim 13, wherein the distal jaw bodies define a curved configuration such that the distal jaw bodies are misaligned with one another as the first jaw member translates from the grasping position to the cutting position.

15. The forceps of claim 14, wherein the distal jaw body defines a stepped tissue contacting portion such that the stepped tissue contacting portions move in a shearing action relative to one another as the first jaw member translates from the grasping position to the cutting position.

16. The clamp of claim 13, wherein the second drive pin defines a first height in a first orientation and a second height in a second orientation, and wherein the pivot slot includes a first portion and a second portion, the second portion of the pivot slot defining a height that is less than the first height and greater than the second height such that when the second drive pin is disposed in the first orientation, movement of the second drive pin into the second portion of the pivot slot is prevented, and when the second drive pin is disposed in the second orientation, movement of the second drive pin into the second portion of the pivot slot is permitted.

17. The forceps of claim 16, wherein the first orientation of the second drive pin corresponds to the spaced-apart position of the first and second jaw members, thereby preventing the first jaw member from translating to the cutting position when the first and second jaw members are disposed in the spaced-apart position.

18. The forceps of claim 13, wherein the first and second drive shafts extend through the outer shaft adjacent to one another.

19. The forceps of claim 13, wherein distal translation of the first drive rod through the outer shaft pivots at least one of the first or second jaw members from the spaced-apart position to the approximated position.

20. The forceps of claim 13, wherein proximal translation of the second drive rod through the outer shaft translates the first jaw member from the grasping position to the cutting position.