SE542609C2

SE542609C2 - A tool gripping device for a laparoscopic instrument

Info

Publication number: SE542609C2
Application number: SE1851029A
Authority: SE
Inventors: Azad Najar
Original assignee: Laprotech Ab
Priority date: 2018-01-29
Filing date: 2018-08-30
Publication date: 2020-06-16
Also published as: SE1851029A1; EP3745964A1

Abstract

The present invention relates to a tool gripping device for a surgical instrument. The tool gripping device comprises a rod having a longitudinal axis A, a distal end and a proximal end. The proximal end of the rod is configured to be attached to a handle assembly and the distal end is provided with a tool holding assembly capable of holding a tool member. The tool gripping device further comprises a hollow sleeve having a distal opening and a proximal end. Said hollow sleeve partially surrounds and is longitudinally and independently displaceable parallel to the longitudinal axis A along an outer surface of said longitudinally extending rod.The tool holding assembly comprises a first shank member and a second shank member. Each of said first and second shank members are provided with a curved flexible portion and a stiff tool holding portion. When said hollow sleeve is displaced along said longitudinal axis A on the outer surface of said longitudinally extending rod, the first and second shank members are moved between an open and a closed position. In the closed position said stiff tool holding portions form a clamping jaw assembly configured to clamp said tool member in a firm grip.

Description

During laparoscopic surgery, operations are performed farfrom their location through smallincisions (usually 0.5-1.5 cm) elsewhere in the body. Laparoscopic surgery provides anumber of advantages to the patient compared to the more common, open surgeryprocedure. Pain and hemorrhaging are reduced due to substantially smaller incisions and recovery times are much shorter.

During laparoscopic surgery the key element is the use of a laparoscope, a long fiber opticcable system which allows viewing of the operation area by snaking the cable from a moredistant, but more easily accessible location. As the surgery is performed at a distance,instruments with long handles are used in order to perform all steps of the operation. lnlaparoscopic procedures a plurality of tubular members e.g. trocars may be inserted throughoffset incisions and advanced proximal to the tissue site of interest. The tubular membersutilized are relatively rigid and of a diameter sufficient to facilitate the passage of a variety ofdevices there through, including for example gas inflation conduits, electrosurgical devices,imaging apparatuses, forceps, scissors, probes, dissectors, hooks, retractors and suturing devices.

An important step in laparoscopic surgery is to effectively suture an internal tissue site ofinterest. Such suturing entails the passage of suture material into and back out of the tissueat least once, and most typically, a plurality of times, followed by the provision of a knot adjacent to the sutured tissue.

Although laparoscopic surgery provides many advantages, one of the disadvantages is thatsometimes the surgeon has a restricted range of motion due to limited space at the surgicalsite, which results in a loss of dexterity. Under certain circumstances the available space atthe surgical site is so restricted that suturing tissues together using a regular laparoscopicinstrument becomes very difficult. ln these situations the suturing procedure may beimproved by changing the grip or angle of the needle or thread to be able to reach and suture tissues together at narrow sites.

Adjusting the grip and/or angle of the needle is currently often achieved by means of forceps.A first pair of forceps holds on to the needle, while a second pair grips the needle at thecorrect location and angle required for suturing. However, once the second pair of forcepshas gripped the needle at a certain angle there is no way to adjust the angle unless the firstpair of forceps again grips the needle and readjusts the grip and/or angle. This may be acumbersome procedure before the correct position and angle for the needle is obtained.Thus, there is a need for a laparoscopic instrument wherein the user can adjust the grip and angle of the laparoscopic tool without the use of multiple forceps.

SUMMARY OF THE INVENTION Viewed from a first perspective, the tool gripping device as described herein canadvantageously be used together with a laparoscopic instrument during laparoscopic surgerywhen there is a need to e.g. adjust the grip and/or the angle of a tool member, such as e.g. asuturing tool member at the surgical site without the use of additional forceps or other instruments. ln particular the invention relates to a tool gripping device that is particularly suitable for usewith a laparoscopic instrument. Said tool gripping device comprises a rod having alongitudinal axis A, a distal end and a proximal end, said proximal end is configured to beattached to a handle assembly of a laparoscopic instrument. Said distal end is provided witha tool holding assembly capable of gripping, holding and manipulating a tool member. Thetool gripping device further comprises a hollow sleeve having a distal opening and a proximalend, said hollow sleeve partially surrounds and is longitudinally and independently displaceable parallel to the longitudinal axis A along an outer surface of said rod.

The tool holding assembly comprises a first shank member and a second shank memberlocated at the distal end of the rod. Each of said first and second shank members areprovided with a curved flexible portion and a stiff tool holding portion, and when said hollowsleeve is displaced along said longitudinal axis A on the outer surface of the rod, therebycovering or uncovering said first and second shank members, the first and second shankmembers are moved between an open and a closed position. ln said closed position, the stiff tool holding portions form a clamping jaw assembly configured to secure said tool member.

The tool member is advantageously a suture needle having a first end provided with apiercing tip, a second end opposite to the first end and a mid-portion having a square orrectangular cross section. The second end of the suture needle is advantageously providedwith an eyelet arranged to hold a suturing thread. Advantageously the tool member iscrescent-shaped. An imaginary axis B extends along the mid-portion, around which axis B the tool member may rotate.

The proximal ends of each of the first and second the shank members comprise a curvedflexible portion made from a resilient material configured to deflect said first and secondshank members away from one another. Consequently the first and second shank membersare arranged to inherently oppose each other, i.e. force them apart to an open position unless an opposing force is applied.

The distal end of the stiff tool holding portion of the first shank member has a claw endedconfiguration and the stiff tool holding portion of the second shank member is shorter thanthe first shank member. Advantageously said claw ended configuration and said stiff toolholding portion of the second shank member, together form a receiving cleft in the clampingjaw assembly configured to receive and surround said tool member in a tight grip when thefirst and second shank members are brought together into a closed position. ln the closedposition, the inner walls of the receiving cleft apply pressure onto all four surfaces of the square/rectangular mid-section of the tool member, clamping it in a firm grip.

The hollow sleeve is displaceable along longitudinal axis A of the rod and is configured toreceive and surround said first and second shank members such that the clamping jawassembly is moved between a relaxed mode wherein the shank member are in an openposition, a tool clamping position wherein the clamping jaw are in a closed position andholding the tool member in a tight grip, and a tool turning mode wherein the tool member is able to slide and rotate inside the clamping jaw.

The relaxed mode of the tool gripping device is reached when said hollow sleeve is displacedin the proximal direction along the longitudinal axis A of said rod, uncovering said first andsecond shank members completely, thereby moving the first and second shank members with the clamping jaw into the open position.

The tool clamping mode of the tool gripping device is reached when said hollow sleeve isdisplaced in the distal direction along the longitudinal axis A of said rod until the stiff toolholding portions and the curved flexible portions of the first and second shank members arecompletely received into the distal opening of the hollow sleeve, moving the first and secondshank members including the clamping jaw assembly into the closed position, and abutting a distal end of said hollow sleeve towards said tool member.

The tool turning mode of the tool gripping device is reached when said hollow sleeve isdisplaced along the longitudinal axis A of said rod until the curved flexible portions and atleast part of said stiff tool holding portions, are received into the distal opening of the hollowsleeve. The tool turning mode enables a user to slide the tool member along a tool memberaxis B, to rotate the tool member 360° around a tool member axis B and to rotate the tool member 360° around the longitudinal axis A of the rod.

The tool turning mode will disengage the rod from a locked position inside the handleassembly, thereby enabling a user to rotate the rod, including the clamping jaw assembly with the tool member, 360° around the longitudinal axis A of the rod.

The proximal end of the rod is provided With a slit configured to cooperate with a resilient locking device.

The distal end of the hollow sleeve is advantageously provided with a longitudinal recess reaching in the proximal direction parallel to the longitudinal axis A. ln a further aspect the invention also relates to a laparoscopic instrument comprising ahandle assembly by which the user may hold the laparoscopic device and a tool grippingdevice capable of holding and manipulating a tool member.

Said tool gripping device comprises a rod having a longitudinal axis A, a distal end and aproximal end, said proximal end is configured to be attached to the handle assembly. Saiddistal end is provided with a tool holding assembly capable of gripping, holding andmanipulating a tool member. The tool gripping device further comprises a hollow sleevehaving a distal opening and a proximal end, and the hollow sleeve partially surrounds and islongitudinally and independently displaceable parallel to the longitudinal axis A along an outer surface of said rod.

The tool holding assembly comprises a first shank member and a second shank member,Each of said first and second shank members are provided with a curved flexible portion anda stiff tool holding portion, and when said hollow sleeve is displaced along said longitudinalaxis A on the outer surface of the rod covering or uncovering said first and second shankmembers, the first and second shank members are moved between an open and a closedposition. ln said closed position, the stiff tool holding portions form a clamping jaw assembly configured to grip said tool member.

The tool member is advantageously a suture needle having a first end provided with apiercing tip, a second end opposite to the first end and a mid-portion having a square orrectangular cross section. The second end of the suture needle is advantageously providedwith an eyelet arranged to hold a suturing thread. Advantageously the tool member iscrescent-shaped. An imaginary axis B extends along the mid-portion, around which the tool member may rotate.

The proximal ends of each of the first and second the shank members comprise a curvedflexible portion made from a resilient material configured to deflect said first and secondshank members away from one another. Consequently the first and second shank membersare arranged to inherently oppose each other, i.e. to be forced apart to an open position unless an opposing force is applied.

The distal end of the stiff tool holding portion of the first shank member has a claw endedconfiguration while the stiff tool holding portion of the second shank member is shorter thanthe first shank member. Advantageously said claw ended configuration and said stiff toolholding portion of the second shank member, together form a receiving cleft in the clampingjaw assembly that receives said tool member and surround said tool member in a tight gripwhen the first and second shank members are brought together into a closed position. ln theclosed position, the inner walls of the receiving cleft apply pressure onto all four surfaces of the square/rectangular mid-section of the tool member, clamping it in a firm grip.

The handle assembly comprises an actuation lever and a housing, said housing comprising aspring and a slider. Said actuation lever is articulated to the hollow sleeve via a first and a second linking arm and the slider.

The first and second linking arms each have a first and a second end, and wherein the firstend of the first linkage arm is connected to the slider, the second end of the first linkage armis connected to the first end of the second linkage arm by means of a sliding pin slidablycoupled in an actuation lever slit arranged in the actuation lever, and the second end of the second linkage arm is connected to the housing.

The actuation lever has one relaxed mode and two working modes; the tool clamping mode and the tool turning mode.

The relaxed mode of the laparoscopic instrument is reached by fully releasing said actuationlever, whereby said hollow sleeve is displaced in the proximal direction along the longitudinalaxis A of said rod, uncovering said first and second shank members completely, thereby moving the clamping jaw assembly into an open position.

The tool clamping mode of the laparoscopic instrument is reached by pressing said actuationlever all the way towards said housing, whereby said hollow sleeve is displaced in the distaldirection along the longitudinal axis A of the rod until the stiff tool holding portions and thecurved flexible portions of the first and second shank members are fully received into thedistal opening of the hollow sleeve, thereby moving said first and second shank members into a closed position, and abutting said tool member with a distal end of said hollow sleeve.

The tool turning mode of the laparoscopic instrument is reached by pressing said actuationlever half way towards the housing, whereby said hollow sleeve is displaced along thelongitudinal axis A of said rod until the curved flexible portions of the first and second shankmembers, and a least part of said stiff tool holding portions, are received into the distal opening of the hollow sleeve.

The tool turning mode enables a user to slide the tool member along a tool member axis B, and to rotate the tool member 360° around a tool member axis B.

The tool turning mode further disengages said rod from a locked position inside the handleassembly, thereby enabling a user to rotate the tool member 360° around the longitudinal axis A of the rod.

The distal end of the hollow sleeve is advantageously provided with a longitudinal recess reaching in the proximal direction parallel to the longitudinal axis A.

DEFINITIONS ln the present disclosure, lt should be noted that the term “proximal” is intended to mean apart of the instrument located closest to the user of the instrument when in normal use, andthe term “distal” is intended to mean a part of the instrument located furthest away from a user (and closest to the patient) during normal handling of the instrument.

BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 discloses a laparoscopic instrument comprising a tool gripping device.

Figure 2 discloses a cross sectional view of the laparoscopic instrument.

Figure 3a discloses the tool gripping device in an open position.

Figure 3b discloses the tool gripping device in a closed position.

Figure 4 discloses the tool member clamped by the tool gripping device.

Figure 5 is a detailed view of the housing Figure 6 is a cross sectional view of the laparoscopic instrument in a relaxed mode.

Figure 7a is a cross sectional view of the laparoscopic instrument in a tool clamping mode.Figure 7b is a cross sectional view of the laparoscopic instrument in a tool turning mode.

Figures 8a - c are detailed views of the tool gripping device and the sliding motion of the tool member along the tool member axis B during the tool turning mode Figures 9a-d are detailed views of the tool gripping device and rotation of the tool member around the tool member axis B during the tool turning mode Figures 10a and b are detailed views of the tool gripping device and rotation of the tool member around the longitudinal rod axis A during the tool turning mode Figures 11a-c are detailed views of the tool gripping device and the combined rotation of thetool member around both the tool member axis B and the longitudinal rod axis A during the tool turning modeFigures 12a and b are views of a further embodiment of the tool gripping deviceFigure 13a is a detailed view of the resilient locking device.

Figure 13b is a detailed view of the rod in a locked position by the resilient locking device.

DETAILED DESCRIPTION Figure 1 is a view of a laparoscopic instrument 100 comprising a handle assembly 130 bywhich the user may hold the laparoscopic device 100, and a tool gripping device 110 whichmay hold a tool member 120. ln the illustrated embodiments the one or more tool members 120 is a curved suturing needle.

The handle assembly 130 comprises a housing 131 and an actuation lever 133 (figures 1and 2). The handle assembly 130 is designed to be held by one hand (left or right) bygripping around the housing 131 and the actuation lever 133. The housing 131 comprises aslider 134 and a spring 135 (explained further below) and the actuation lever 133 is in oneembodiment provided with a finger grip 136 to enable safe and precise handling of the laparoscopic instrument 100.

The tool gripping device 110 comprises a long rod 170 having a longitudinal axis A, a distal end 171 and a proximal end 172 (see figure 2). The rod 170 extends from the distal end 171of the laparoscopic device 110, through the entire handle assembly 130 (see figure 2) and isat its proximal end 172 attached to a resilient locking device 132 arranged on the exterior of the handle assembly 130.

The distal end 171 of the rod 170 is designed as a tool holding assembly 150 (see figure 3a)capable of holding a tool member (not shown). The distal end 171 of the rod 170 is split intotwo parts along its longitudinal axis A forming a first shank member 151 and a second shankmember 152. The first and second shank members 151, 152 together form the tool holdingassembly 150. Each shank member 151, 152 is provided with a stiff tool holding portion 153,154 arranged at the distal end 171, and a flexible portion 155, 156 arranged at the moreproximal end of the each shank member 151, 152. The flexible portions 155, 156 arearranged to oppose one another, i.e. they will inherently make the first and second shank members 151, 152 deflect away from each other in the absence of a force keeping said shank members 151, 152 together. When brought togetherthe stiff tool holding portions 153,154 of the shank members 151, 152 together form a clamping jaw assembly 157 (see figure 3b) configured to hold a tool member 120.

The stiff tool holding portion 153 on the first shank member 151 is provided with a claw-ended conformation 158 at its distal end 171, while the stiff tool holding portion 154 of thesecond shank member 152 is slightly shorter than the first shank member 151. Together theyform a receiving cleft 160 in the clamping jaw assembly 157 (see figure 3b) which will receiveand surround said tool member 120 in a tight grip between the first and second shankmembers 151, 152. ln the illustrations the tool member 120 is a curved suture needle having a first end providedwith a piercing tip 122, a second end 123 opposite the first end, and a mid-portion 124 (asillustrated in figure 4). The second end may be provided with an eyelet arranged to receive asuturing thread 126. The mid-portion 124 of the tool member 120 has a square or rectangularcross section configured to fit in the receiving cleft 160 formed when the first shank member151 and the second shank member 152 (see figures 3b and 4) are brought together.Although the tool member is curved in the illustrations herein, an imaginary axis B can befound that extends parallel to the mid-portion 124 of the tool member 120 around which thetool member 120 may turn when the tight grip of the clamping jaw assembly 157 is eased inthe tool turning mode as described further below. The square or rectangular cross sectionprevents rotation or sliding of the tool member 120 in the tool clamping mode keeping it firmly clamped in the receiving cleft 160.

The tool gripping device 110 further comprises a hollow sleeve 180 (see figures 1-4). Thehollow sleeve 180 has a distal end and a proximal end 182. The distal end is provided withan opening 181, while the proximal end 182 of the hollow sleeve 180 is attached to a slider134 inside the housing 131 (see figure 5) of the handle assembly 130 as explained furtherbelow. The hollow sleeve 180 has an extension in its longitudinal direction whichsubstantially exceeds its extension in the transverse direction. The longitudinal extension ofthe hollow sleeve 180 is at least 5 times, at least 10 times, such as more than 15 times longer than its transverse extension.

The hollow sleeve 180 receives and surrounds the rod 170 and extends along substantiallythe entire length of said rod 170.The hollow sleeve 180 is configured to be longitudinally andindependently displaceable parallel to the longitudinal axis A along the outer surface of saidrod 170 (see figures 2, 3a, 3b and 4). By displacing the hollow sleeve 180 along thelongitudinal axis A of the rod 170, the clamping jaw assembly 157 can be moved between an open and closed position as will be explained below.

The actuation lever 133 which forms part of the handle assembly 130 is articulated to thehollow sleeve 180 via a first and a second linking arm 137, 138 and a slider 134 (see figures2, 5 and 6). Said first and second linking arms 137, 138 each have a first and a second end139, 140, 141, 142, wherein the first end 139 of the first linking arm 137 is rotatablyconnected to the slider134 located inside the housing 131. The first end 139 of the firstlinking arm 137 is mounted to the slider134 by means of a first mounting pin 143 aroundwhich the first end 139 of the first linking arm 137 may rotate. The first and second linkingarms 137, 138 are connected to each other by means of a sliding pin 144 slidably coupled inan actuation lever slit 145 on the actuation lever 133. The second end 142 of the secondlinking arm 138 is rotatably connected to the housing 131 by means of a second mounting pin 146 around which the second end 142 of the second linking arm 138 may rotate.

When not in use the laparoscopic device 110 is in a relaxed mode. ln the relaxed mode theuser releases any force pushing applied on said actuation lever 133, whereby the hollowsleeve 180 is displaced in the proximal direction along said longitudinal axis A of the rod 170completely uncovering the stiff holding portions 153, 154 and the flexible portions 55, 156 ofthe shank members 151, 152). ln this mode the clamping jaw assembly 157 is in an openposition due to the inherent resilient opposing power of the curved flexible portions 155, 156keeping the first and second shank members 151, 152 apart (see figures 3a and 6). ln the open position a tool member 120 may be placed in the tool holding assembly 150.

When a user of the laparoscopic instrument 100 presses the actuation lever 133 towards thehousing 131, the actuation lever 133 may reach one of two different working modes; the tool clamping mode (figure 7a) or the tool turning mode (figure 7b).

The tool clamping mode is reached when the actuation lever 133 is pressed all the waytowards the housing 131 (see arrow 147A in figure 7a). ln this mode the sliding pin 144slides towards the distal end 171 of the handle assembly 130, increasing the obtuse angle ßbetween the first and second linking arms 137, 138, thereby pushing the slider 134 towardsthe distal end of the handle assembly 130 (see arrow 147B in figure 7a). The slider134 isresiliently biased towards the proximal end of the housing 131 by means of an opposingspring 135 (see dashed arrow in figure 7a). As the hollow sleeve 180 is coupled to the slider,the sleeve 180 is displaced along the longitudinal axis A towards the distal end 171 of the rod170.

When the hollow sleeve 180 is displaced in towards the distal end 171, the curved flexibleportions 155, 156 of as well as the tool holding portions 153, 154 of the first and secondshank members 151, 152 enter the distal opening 181 of the hollow sleeve 180 causing the first and second shank members 151, 152 to flex towards each other to a closed position (see figures 4 and 7a). As the tool holding portions 153, 154 of the tool holding assembly 150are made from a stiff material that will not flex when a pressure or force is applied thereto,the shank members 151, 152 will force the tool holding portions 153, 154 together in a closeabutment, thereby closing the clamping jaw assembly 157 around the tool member 120 (see insert of see figure 7a).

When the hollow sleeve 180 is displaced all the way towards the distal end 171 of the rod170, abutting said claw-end 158, the distal end of the hollow sleeve 180 will press the toolmember 120 towards the claw-end 158 of the rod 170 in a tight grip. ln this tool clampingmode, walls forming the receiving cleft 160 will firmly abut all four sides of thesquare/rectangular tool member 120 mid-portion 124, thereby preventing the tool member 120 from sliding or rotating in the clampingjaw157 (not shown).

The resilient spring 135 provides an opposing force (see dashed arrow in figure 7a) to thepressure provided when the actuation lever 133 is pressed towards the housing 131.Consequently the hollow sleeve 180 will automatically move in the proximal direction alongthe rod 170 and parallel to the longitudinal axis A towards the handle assembly 130 when the actuation lever 133 is released.

The clamping jaw 157 will automatically open when the hollow sleeve 180 is fully retractedfrom the flexible portions 155, 156 of the first and second shank members 151, 152, thereby releasing the tool member 120 from the receiving cleft 160.

The tool turning mode is reached when the actuation lever 133 is pressed only half thedistance or less towards the housing 131 (see arrow 148A in figure 7b). ln this mode thesliding pin 144 slides towards the proximal end of the handle assembly 130, increasing theobtuse angle ß between the first and second linking arms 137, 138 compared to the relaxedmode. The tool turning mode can also be reached from the tool clamping mode by releasingthe pressure on the actuation lever 113 slightly, thereby causing a displacement of the hollowsleeve opening 181 along the longitudinal axis A of the rod 170 in the proximal directiontowards the handle assembly 130 to remove the abutment of the distal end of the hollowsleeve 180 from the tool member 120. The stiff tool holding portions 153, 154 are at least partially uncovered by the hollow sleeve 180 in the tool turning position (see figure 3b).

The displacement of the hollow sleeve 180 away from the tool member 120, will widen thereceiving cleft 160 slightly, thereby easing the tight clamping grip of the tool member 120such that the mid-portion 124 of the tool member may slide in either direction along axis B ofthe mid-portion 124 inside the receiving cleft 160 (see figures 8a-8c). This may be veryadvantageous when, for example, the operator wants to relocate the piercing tip 122 of the tool member 120 closer or further away from the clamping jaw 157. 11 ln some situations it is also useful to be able to rotate the tool member 120 in order to place itin an optimal position for surgery. The eased grip of the clamping jaw 157 will also enable thetool member 120 to rotate 360° around its own axis B (see figures 9a-9d), enabling the userof the laparoscopic instrument to position the tip 122 of the tool member 120 in an optimalposition in relation to the surgical site. Starting from the tool clamping mode, the user simplyeases the grip around the actuation lever 133 to reach the tool turning mode, and abuts oneend of the tool member 120 (either piercing tip 122, or second end 123) towards a tissuesurface at the surgical site, such that the tool member 120 turns around the axis B of its mid-portion 124 until the desired position of the tool member 120 is reached inside the receivingcleft 160 (see figures 9a-9d). Thereafter the user again presses the actuation lever 133 allthe way towards the housing in order to reach the tool clamping mode wherein the toolmember 120 again becomes firmly clamped inside the receiving cleft 160 and unable to rotate or slide.

A further advantageous feature enabled by the tool turning mode, is that when this mode isreached, the proximal end 172 of the rod 170 becomes disengaged from its locked positioninside the handle assembly 130, thereby permitting the rod 170 to rotate freely around itslongitudinal axis A. This enables the user to position the piercing tip 122 to point in any direction required by the surgical task (see figures 10a-b). ln order to change direction of the piercing tip 122 for example 180°, the user eases the griparound the actuation lever 133 to reach the tool turning mode. ln this position the rod 170,and thereby the complete tool holding assembly 150 including the tool member 120, is ableto rotate 360° around its longitudinal axis A inside the handle assembly 130. Having reachedthe tool turning mode, the user abuts one end of the tool member 120 (either the piercing tip122, or second end 123) towards a tissue surface at the surgical site, and while keeping thegrip around the actuation lever 133, and the tool holding assembly 150 firmly abuttedtowards the tissue surface, the user turns the entire handle assembly 130 180° in either theclock-wise or counter clock-wise direction around the axis A of the rod 170. As the rod 170has been disengaged from the locked position inside the handle assembly, the handleassembly will rotate freely around the axis A of the rod at its proximal end 172, while the firmabutment of the tool holding assembly 150 at the distal end 171 of the rod 170 is stillmaintained at the tissue site. When the desired change in direction (i.e. rotation of handleassembly 130 in relation to the tool member 120) has been reached, the user again pressesthe actuation lever 133 all the way towards the housing 131 in order to reach the toolclamping mode, whereby the rod 170 again enters into a locked position inside the handle assembly 130 and further rotation is prevented. 12 lt is not necessary to separate the rotational movements around axis A and B as the toolturning mode allows simultaneous rotation of the tool member 120 around the tool memberaxis B and the rod longitudinal axis A (see figures 11a-c). As can be seen in figures 11a andb, the tool member has been rotated 90° around the axis A from having the piercing tip 122pointing upwards towards the left of the device (when viewed from the user) in figure 11awhile simultaneously pressing the second end 123 of the tool member 120 towards a tissuesite 90° around the axis B in the clock-wise direction (when viewed from the user) to point in the downward and distal direction. ln this position the user changes from the tool clamping mode to the tool turning mode androtates handle assembly 90° in the clockwise direction around the rod A-axis and 90° aroundthe mid-portion B-axis to have the tip 122 relocated and point downwards and in the distal direction (see figure 11b) The simple switching between the tool clamping mode and the tool turning mode is veryadvantageous as the user of the laparoscopic instrument is able to change the position of thetool member freely into any position required by the surgical task using only one hand. Thismay be very advantageous when for example the operator wants to relocate the piercing tip122 of the tool member 120 closer or further away from the clamping jaw 157, rotate the toolmember 120 around its own axis B, or maybe flip the tool member 120 180° to have it point in the opposite direction.

Examples of this advantageous handling are show in figures 11a-c. ln figure 11a, thepiercing tip 122 of the tool member 120 points upwards towards the left of the device (whenviewed from the user). From this position the tool member has been rotated 90° around therod axis A in the counter-clockwise direction (when viewed from the user), and 90° aroundthe mid-portion B-axis towards the distal end such that the piercing tip 122 now points in thedownwards and distal direction (see figure 11b). From the direction in figure 11b, the toolmember may be rotated a further 90° around the rod A-axis in the clockwise direction, and90° around the mid-portion B-axis in the proximal direction to now point upwards and towards the right of the device (when viewed from the user) as seen in figure 11c.

By using the laparoscopic instrument 100 as described herein a tool member 120 may bereleased, rotated, turned and gripped continuously without the use of further tools, and using only a one-hand grip.

Figures 12a and b disclose a further embodiment of the laparoscopic instrument describedherein. ln this embodiment the distal end hollow sleeve 180 is provided with a longitudinalrecess 200 reaching in the proximal direction along the longitudinal axis A (see figure 12a).

The recess 200 is configured to accommodate the mid-portion of the tool member 120. For 13 this embodiment the user Will displace the hollow sleeve 180 in the distal direction along therod 170 to receive the shank members 151, 151 inside the hollow sleeve 180, therebyclosing the clamping jaw assembly 157 around the tool member 120 (as described above).When entering the clamping mode, the mid-portion of the tool member 120 is received intothe recess 200 on the hollow sleeve 180, while the hollow sleeve distal edge opposite therecess 200 will abut the tool member mid-portion. ln this embodiment the mid-portion of thetool member 120 will not be clamped in a direction that extends perpendicular to the hollowsleeve edge (and the longitudinal axis A), but will abut the hollow sleeve edge at an angle(see figure 12b) which will depend on the depth of the recess 200. This enables the user to direct the tool member 120 and the piercing tip 122 at a required angle. ln a further embodiment the hollow sleeve 180 may be provided with more than one recess200, such as two, three of four recesses 200 of different depths (not shown). ln thisembodiment the tool member 120 may be tilted to different angles according to need,depending on the number of recesses 200 with different depths provided around the edge of the hollow sleeve 180.

After use the laparoscopic device 100 has to be disassembled in order to be able to clean allparts that have been in contact with a patient. As mentioned above the longitudinal extendingrod 170 extends through the handle assembly 130 and is attached to a resilient lockingdevice 132 arranged on the exterior of the handle assembly 130. The resilient locking device132 comprises a nut 191 With a through bore and a resilient shackle 192 provided with anotch 193 shaped as a keyhole (see figure 13a). The proximal end 172 of the rod 170 isprovided with a slit 195 configured to cooperate with the keyhole-shaped notch 193 of theresilient shackle 192. When the proximal end 172 of the rod 170 exits the handle assembly130, it passes through a loop 194 of the shackle 192, the through bore of the nut 191 andthereafter the slit 195 at the proximal end 172 is fitted into the narrow part of the keyhole-shaped notch 193 (see figure 13b). ln order to disassemble the laparoscopic device, the slit195 at the proximal end 172 of the rod 170 is dislodged from the narrow end of the keyhole-shaped notch 193 and the rod 170 can be pulled out from the handle assembly.

Claims

CLA||\/IS

1. A tool gripping device (1 10) for a laparoscopic instrument (100) comprising - a rod (170) having a longitudinal axis A, a distal end (171) and a proximal end(172), said proximal end (172) is configured to be attached to a handle assembly(130), said distal end (171) is provided with a tool holding assembly (150) capable ofholding a tool member (120); and - a hollow sleeve (180) having a distal opening (181) and a proximal end (182), saidhollow sleeve (180) partially surrounding and being longitudinally and independentlydisplaceable parallel to the longitudinal axis A along an outer surface of said rod(170), characterized in that said tool holding assembly (150) comprises a first shank member (151) and a secondshank member (152), said first and second shank members (151, 152) each having acurved flexible portion (155, 156) and a stiff tool holding portion (153, 154), and whensaid hollow sleeve (180) is displaced along said longitudinal axis A on the outersurface of the rod (170), covering or uncovering said first and second shankmembers (151, 152), said first and second shank members (151, 152) are movedbetween an open and a closed position, wherein said closed position, the stiff toolholding portions (152, 153) form a clamping jaw assembly (157) configured to clamp said tool member (120) in a firm grip.

2. The tool gripping device (110) according to claim 1, wherein said tool member(120) is a suture needle having a first end provided with a piercing tip (122), a secondend (123) opposite to the first end and a mid-portion (124) having a square or rectangular cross section.

3. The tool gripping device (110) according to claim 2, wherein said curved flexibleportions (155, 156) of the first and second shank members (151, 152) are made froma resilient material and are configured to deflect said first and second shank members (151, 152) away from one another.

4. The tool gripping device (110) according to any one of the preceding claims,wherein said stiff tool holding portion (153) of the first shank member (151) has a claw ended configuration (158).

5. The tool gripping device (110) according to any one of the preceding claims,wherein said stiff tool holding portion (154) of the second shank member (152) is shorter than the first shank member (151 ).

6. The tool gripping device (110) according to claims 4 and 5, wherein said claw ended configuration (158) and said stiff tool holding portion (154) of the second shank member (152), together form a receiving cleft (160) in the clamping jaw assembly (157) that receives said tool member (120).

7. The tool gripping device (110) according to any one of the preceding claims,wherein a relaxed mode for the tool gripping device (110) is reached when saidhollow sleeve (180) is displaced in a proximal direction along the longitudinal axis Aof said rod (170) uncovering said first and second shank members (151, 152)completely, thereby moving the first and second shank members (151, 152) into the open position.

8. The tool gripping device (110) according to any one of the preceding claims,wherein a tool clamping mode for the tool gripping device (110) is reached when saidhollow sleeve (180) is displaced in the distal direction along the longitudinal axis A ofsaid rod (170) until the stiff tool holding portions (153, 154) and the curved flexibleportions (155, 156) of the first and second shank members (151, 152) are completelyreceived into the distal opening (181) of the hollow sleeve (180), moving the first andsecond shank members (151, 152) including the clamping jaw assembly (157) intothe closed position, and abutting a distal end of said hollow sleeve 180 towards said tool member 120.

9. The tool gripping device (110) according to any one of the preceding claims,wherein a tool turning mode for the tool gripping device (110) is reached when saidhollow sleeve (180) is displaced along the longitudinal axis A of said rod (170) untilthe curved flexible portions (155, 156) and at least part of said stiff tool holdingportions (153, 154), are received into the distal opening (181) of the hollow sleeve(180).

10. The tool gripping device (110) according to claim 9, wherein the tool turning mode enables the user to slide the tool member (120) along a tool member axis B.

11. The tool gripping device (110) according to claim 9, wherein the tool turningmode enables the user to rotate the tool member (120) 360° around a tool member axis B.

12. The tool gripping device (110) according to claim 9, wherein the tool turningmode, the rod (170) is disengaged from a locked position inside the handle assembly(130), thereby enabling the user to rotate the tool member (120) 360° around thelongitudinal axis A of the rod (170).

13. The tool gripping device (110) according to any one of the preceding claims,wherein the proximal end (172) of the rod (170) is provided with a slit (195) configured to cooperate with a resilient locking device (132).

14. The tool gripping device (110) according to any one of the preceding claims,wherein the distal end of the hollow sleeve 180 is provided with a longitudinal recess 200 reaching in the proximal direction parallel to the longitudinal axis A.

15. A laparoscopic instrument (100) comprising - a handle assembly (130) by which the user may hold the laparoscopic device (130);and - a tool gripping device (110) capable of holding a tool member (120); said tool gripping device (110) comprising - a rod (170) having a longitudinal axis A, a distal end (171) and a proximal end(172), said proximal end (172) is configured to be attached to a handle assembly(130), said distal end (171) is provided with a tool holding assembly (150) capable ofholding a tool member (120); and - a hollow sleeve (180) having a distal opening (181) and a proximal end (182), saidhollow sleeve partially surrounding and being longitudinally and independentlydisplaceable parallel to the longitudinal axis A along an outer surface of said rod(170), characterized in that said tool holding assembly (150) comprises a first shank member (151) and a secondshank member (152), said first and second shank members (151, 152) each having acurved flexible portion (155, 156) and a stiff tool holding portion (152, 153), and whensaid hollow sleeve (180) is displaced along said longitudinal axis A on the outersurface of the rod (170), covering or uncovering said first and second shankmembers (151, 152), said first and second shank members (151, 152) are movedbetween an open and a closed position, wherein said closed position, said stiff toolholding portions (152, 153) form a clamping jaw assembly (157) configured to hold said tool member (120).

16. The laparoscopic instrument (100) according to claim 15, wherein said toolmember (120) is a suture needle having a first end provided with a piercing tip (122),a second end (123) opposite to the first end and a mid-portion (124) having a square or rectangular cross section.

17. The laparoscopic instrument (100) according to any one of the preceding claims15-16 wherein said curved flexible portions (155, 156) of the first and second shankmembers (151, 152) are made from a resilient material and configured to deflect said first and second shank members (151, 152) away from one another.

18. The laparoscopic instrument (100) according to any one of the preceding claims15-17, wherein said stiff tool holding portion (153) of the first shank member (151) has a claw ended configuration (158).

19. The laparoscopic instrument (100) according to any one of the preceding claims15-18, wherein said stiff tool holding portion (154) of the second shank member (152) is shorter than the first shank member (151 ).

20. The laparoscopic instrument (100) according to claims 18-19, wherein said clawended configuration (158) and said stiff tool holding portion (154) of the second shankmember (152), together form a receiving cleft (160) in the clamping jaw assembly (157) to clamp said tool member (120) in a firm grip.

21. The laparoscopic instrument (100) according to any one of the preceding claims15-20, wherein the proximal end (172) of the rod (170) is provided with a slit (195) configured to cooperate with a resilient locking device (132).

22. The laparoscopic instrument (100) according to any one of the preceding claims15-21, wherein said handle assembly (130) comprises an actuation lever (133) and a housing (131), said housing (131) comprising a spring (135) and a slider (134).

23. The laparoscopic instrument (100) according to claim 22, wherein saidactuation lever (133) is articulated to the hollow sleeve (180) via a first and a secondlinking arm (137, 138) and the slider (134).

24. The laparoscopic instrument (100) according to claim 23, wherein said first andsecond linking arms (137, 138) each have a first and a second end (139, 140, 141,142), and wherein the first end (139) of the first linkage arm (137) is connected to theslider (134), the second end (140) of the first linkage arm (137) is connected to thefirst end (141) of the second linkage arm (138) by means of a sliding pin (144)slidably coupled in an actuation lever slit (145) arranged in the actuation lever (133),and the second end (142) of the second linkage arm (138) is connected to thehousing (131).

25. The laparoscopic instrument (100) according to any one of the preceding claims22-24, wherein said actuation lever (133) has one relaxed mode and two working modes; the tool clamping mode and the tool turning mode.

26. The laparoscopic instrument (100) according to claim 25, wherein said relaxedmode is reached by fully releasing said actuation lever (133), whereby said hollow sleeve (180) is displaced in the proximal direction along the longitudinal axis A of said rod (170), uncovering said first and second shank members (151, 152) and moving the clamping jaw assembly (157) into an open position.

27. The laparoscopic instrument (100) according to c|aim 25, wherein said toolclamping mode is reached by pressing said actuation lever (133) all the way towardssaid housing (131), whereby said hollow sleeve (180) is displaced in the distaldirection along the longitudinal axis A of the rod (170) until the stiff tool holdingportions (153, 154) and the curved flexible portions (155, 156) of the first and secondshank members (151, 152) are fully received into the distal opening (181) of thehollow sleeve (180), thereby moving said first and second shank members (151, 152)into a closed position, and abutting said tool member (120) with a distal end of said hollow sleeve 180.

28. The laparoscopic instrument (100) according to c|aim 25, wherein said toolturning mode is reached by pressing said actuation lever (133) half way towards thehousing (131), whereby said hollow sleeve (180) is displaced along the longitudinalaxis A of said rod (170) until the curved flexible portions (155, 156) of the first andsecond shank members (151, 152), and a least part of said stiff tool holding portions (153, 154), are received into the distal opening (181) of the hollow sleeve (180).

29. The laparoscopic instrument (100) according to c|aim 26, wherein the toolturning mode enables a user to slide the tool member (120) along a tool member axisB.

30. The laparoscopic instrument (100) according to c|aim 26, wherein the toolturning mode enables a userto rotate the tool member (120) 360° around a tool member axis B.

31. The laparoscopic instrument (100) according to c|aim 26, wherein the toolturning mode disengages said rod (170) from a locked position inside the handleassembly (130), thereby enabling a user to rotate the tool member (120) 360° aroundthe longitudinal axis A of the rod (170).

32. The laparoscopic instrument (100) according to any one of the preceding claims15-31, wherein the proximal end (172) of the rod (170) is provided with a slit (195) configured to cooperate with a resilient locking device (132).

33. The laparoscopic instrument (100) according to any one of the preceding claims15-32, wherein the distal end of the hollow sleeve 180 is provided with a longitudinal recess 200 reaching in the proximal direction parallel to the longitudinal axis A.