WO2016169036A1

WO2016169036A1 - Hyperfine dissection vessel sealing divider device with leapfrogging function

Info

Publication number: WO2016169036A1
Application number: PCT/CN2015/077335
Authority: WO
Inventors: Weijiang Ding; Jianjiang Chen; Jose E. Almeida
Original assignee: Covidien LP
Current assignee: Covidien LP
Priority date: 2015-04-24
Filing date: 2015-04-24
Publication date: 2016-10-27
Anticipated expiration: 2017-10-24
Also published as: CN106063721B; CN205885520U; CN106063721A

Abstract

An electrosurgical instrument (1) includes an end effector (115) having first and second jaw members (150, 160) disposed about a longitudinal axis (z). The first and second jaw members (150, 160) include proximal portions (150a, 160a) defining a gap (G _J) therebetween and distal portions (150b, 160b) having first and second tissue contacting surfaces (152, 162), respectively, and shear edges at opposed sides (154, 164) of the first and second tissue contacting surfaces (152, 162). The end effector (115) is configured to selectively communicate electrosurgical energy between the first and second tissue contacting surfaces (152, 162) of the first and second jaw members (150, 160) upon actuation thereof. At least one of the first and second jaw members (150, 160) is movable relative to the other between an open position, a first approximated position in which the first and second tissue contacting surfaces (152, 162) are substantially opposed to each other, and a second approximated position in which the first and second tissue contacting surfaces (152, 162) are laterally offset with respect to each other.

Description

HYPERFINE DISSECTION VESSEL SEALING DIVIDER DEVICE WITH LEAPFROGGING FUNCTION

BACKGROUND

1.Background of Related Art

The present disclosure relates to energy-based surgical instruments and, more particularly, to energy-based surgical forceps configured for treating and/or cutting tissue.

2.Technical Field

A forceps or hemostat is a plier-like instrument which relies on mechanical action between its jaws to grasp, clamp, and constrict tissue. Energy-based forceps utilize both mechanical clamping action and energy, e.g., electrosurgical energy, ultrasonic energy, light energy, microwave energy, heat, etc., to affect hemostasis by heating tissue to coagulate and/or cauterize tissue. Certain surgical procedures require more than simply cauterizing tissue and rely on the unique combination of clamping pressure, precise energy control, and gap distance (i.e., distance between opposing jaws when closed about tissue) to “seal” tissue. Typically, once tissue is sealed, the surgeon has to accurately sever the tissue along the newly formed tissue seal. Accordingly, many tissue sealing instruments have been designed to incorporate a blade that is movable with respect to a blade slot disposed in a jaw of the tissue sealing instrument to sever the tissue after forming a tissue seal.

Tissue sealing instruments that include a blade and blade slot, however, are typically single-use devices as the blade and blade slot may be difficult to clean, and the blade may wear and dull with repeated use. The incorporation of a blade slot into a jaw of a tissue sealing instrument may reduce the sealing strength of the jaw, and the width of the blade slot may increase the width of the jaw which, in turn, may result in a reduction in the dissection capabilities of the tissue sealing instrument.

SUMMARY

The present disclosure is directed to reusable energy-based surgical instruments having movable, opposed jaw members that are configured for grasping, sealing, dissecting, and/or cutting vessels/tissue without the use of a blade and slot jaw configuration, and with leapfrogging sealing/cutting functions for preventing injury to tissue surrounding the treated vessel/tissue.

In accordance with aspects of the present disclosure, an electrosurgical instrument includes an end effector having first and second jaw members disposed about a longitudinal axis. The first jaw member includes a proximal portion and a distal portion having a first tissue contacting surface, and the second jaw member includes a proximal portion and a distal portion having a second tissue contacting surface. The proximal portions of the first and second jaw members define a gap therebetween and the distal portions of the first and second jaw members have shear edges at opposed sides of the first and second tissue contacting surfaces. The end effector is configured to selectively communicate electrosurgical energy between the first and second tissue contacting surfaces of the first and second jaw members upon actuation thereof. At least one of the first and second jaw members is movable relative to the other between an open position, a first approximated position in which the first and second tissue contacting surfaces are substantially opposed to each other, and a second approximated position in which the first and second tissue contacting surfaces are laterally offset with respect to each other.

In some aspects, the proximal portions of the first and second jaw members extend along the longitudinal axis and the distal portions are longitudinally and laterally twisted with respect to the longitudinal axis. In some aspects, the first and second tissue contacting surfaces define a triangular-shaped gap therebetween when in the first approximated position.

In some aspects, the distal portions of the first and second jaw members include complementary-shaped leading ends that have a different geometry from that of the first and second tissue contacting surfaces. In aspects, one of the complementary-shaped leading ends includes a protuberance and one of the complementary-shaped leading ends includes a recessed surface. In certain aspects, the leading end of the first jaw member includes a convex surface and the leading end of the second jaw member includes a concave surface. The complementary-shaped leading ends may be configured to mate when in the first approximated position, and to be laterally offset with respect to one another when in the second approximated position.

Another electrosurgical instrument provided in accordance with aspects of the present disclosure includes an end effector having first and second jaw members disposed about a longitudinal axis. The first jaw member defines a first tissue contacting surface and the second jaw member defines a second tissue contacting surface. At least one of the first and second jaw members is movable relative to the other between an open position, a first approximated position in which the first and second tissue contacting surfaces are substantially opposed to each other, and a second approximated position in which the first and second tissue contacting surfaces are laterally offset with respect to each other. The instrument further includes first and second shaft members that cooperate to define the end effector. The first jaw member is disposed on a distal end portion of the first shaft member and the second jaw member is disposed on a distal end portion of the second shaft member. The first and second shaft members are coupled together by a pivot pin assembly extending through openings defined in respective intersection portions of the first and second shaft members. At least one of the first and second shaft members is pivotable with respect to the other of the first and second shaft members about two different axes that are substantially orthogonal to each other and the longitudinal axis so as to permit movement of the at least one of the first and second jaw members between the open position, the first approximated position, and the second approximated position.

In some aspects, the pivot pin assembly includes a spring pin and a substantially semispherical pin head. The spring pin has a body portion, a resilient flange disposed at a first end of the body portion, and a tail portion extending from a second end of the body portion and into an opening defined in the pin head. In some aspects, the flange is positioned against the second shaft member and the pin head is positioned in the opening of the intersection portion of the first shaft member. In some aspects, when the first and second shaft members are in the first approximated position, a distal gap is opened between the intersection portions of the first and second shaft members and a proximal gap defined between the intersection portions is closed. In some aspects, when the first and second shaft members are in the second approximated position, a proximal gap is opened between the intersection portions of the first and second shaft members and a distal gap defined between the intersection portions is closed.

The electrosurgical instrument may further include first and second handle members disposed at proximal end portions of the first and second shaft members. In some aspects, the first handle member includes a raised rail and the second handle member includes a bump stopper. In some aspects, the electrosurgical instrument further includes a connector assembly releasably engaged with the raised rail of the first handle member. In certain aspects, the bump stopper engages a switch disposed in the connector assembly when the first and second shaft members are in the first approximated position to automatically activate a source of electrosurgical energy.

In accordance with aspects of the present disclosure, a method of treating tissue includes: latching first and second handle members of an electrosurgical forceps together to effect movement of first and second jaw members from an open position to a first approximated position to grasp tissue between first and second tissue contacting surfaces disposed on distal portions of the first and second jaw members, where proximal portions of the first and second jaw members define a gap therebetween and do not grasp tissue disposed within the gap； applying electrosurgical energy to the tissue grasped between the first and second tissue contacting surfaces of the first and second jaw members to seal the tissue； and laterally moving at least one of the first and second handle members relative to the other to effect movement of the first and second jaw members from the first approximated position to a second approximated position to cut the tissue grasped between the first and second tissue contacting surfaces via shear edges disposed at opposed sides of the first and second tissue contacting surfaces.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects and features of the present disclosure are described herein with reference to the drawings wherein corresponding reference characters indicate corresponding parts throughout the drawings, and wherein:

FIG. 1 is a side view of an open electrosurgical forceps in accordance with an embodiment of the present disclosure；

FIG. 2 is a side, perspective view of the forceps of FIG. 1 with parts separated；

FIG. 3A is an enlarged, perspective view of a spring pin of a pivot pin assembly of the forceps of FIG. 2；

FIG. 3B is a cross-sectional view of the spring pin of FIG. 3A；

FIG. 3C is a cross-sectional view of the spring pin of FIG. 3A in a deflected position；

FIGS. 4A and 4B are enlarged, perspective views of portions of the forceps of FIG. 1, shown along the areas of

detail

4A and 4B, respectively, identified in FIG. 1；

FIG. 5A is a side, perspective view of the forceps of FIG. 1 in a first approximated position；

FIG. 5B is a cross-section view of intersection portions of the forceps of FIG. 5A, taken along line 5B-5B of FIG. 5A；

FIG. 5C is a cross-sectional view of jaw members of the forceps of FIG. 5A, taken along line 5C-5C of FIG. 5A, and including tissue disposed between the jaw members；

FIG. 6A is a side, perspective view of the forceps of FIG. 1 in a second approximated position；

FIG. 6B is a cross-section view of intersection portions of the forceps of FIG. 6A, taken along line 6B-6B of FIG. 6A；

FIG. 6C is a cross-sectional view of jaw members of the forceps of FIG. 6A, taken along line 6C-6C of FIG. 6A, and including tissue disposed between the jaw members；

FIGS. 7A-7C are schematic views of a vessel and tissue in an initial state, after sealing, and after cutting, respectively；

FIG. 8A is a side view of an electrosurgical instrument including a forceps and a connector assembly in accordance with another embodiment of the present disclosure, shown in a disassembled state；

FIG. 8B is a top view of the forceps of the FIG. 8A；

FIG. 9 is an enlarged, perspective view of distal end portions of the forceps of FIG. 8A；

FIG. 10 is a side view of the electrosurgical instrument of FIG. 8A in an assembled state with the forceps in a first approximated position and tissue disposed between jaw members of the forceps；

FIGS. 11A-11 D are side, perspective views of the jaw members of FIG. 10 during movement from the first approximated position to a second approximated position； and

FIG. 12 is a schematic illustration of a work station configured for use with an electrosurgical instrument of the present disclosure.

DETAILED DESCRIPTION

In this disclosure， the term “proximal”refers to a portion of a structure closer to an operator， while the term “distal” refers to a portion of the same structure further from the operator. As used herein， the term “subject” refers to a human patient or animal. The term “operator” refers to a doctor (e.g.， a surgeon) ， a nurse， and other clinicians or care providers, and may include support personnel. The terms “generally， ” “substantially， ” and “about” shall be understood as words of approximation that take into account relatively little to no variation in the modified term (s) .

Referring now to FIG. 1, an electrosurgical instrument 1 in accordance with an embodiment of the present disclosure is configured for grasping, electrically sealing, and mechanically dissecting tissue and/or vessels in open and/or laparoscopic surgical procedures. The electrosurgical instrument 1 includes a reusable forceps 100 releasably connectable to a source of electrosurgical energy (not shown) via

cables

101 and 103, although in other embodiments only one cable is provided.

The forceps 100 includes a first elongated shaft member 110 pivotably coupled to a second elongated shaft member 120. The first elongated shaft member 110 includes proximal and

distal end portions

112 and 114, respectively, and the second elongated shaft member 120 includes proximal and

distal end portions

122 and 124, respectively. The

proximal end portions

112 and 122 of the first and

second shaft members

110 and 120 include first and

second handle members

130 and 140, respectively. The first and

second handle members

130 and 140 are configured to allow an operator to effect movement of one or both of the first and

second shaft members

110 and 120 relative to the other. The

distal end portions

114 and 124 of the first and

second shaft members

110 and 120 cooperate to define an end effector assembly 115 having opposed first and

second jaw members

150 and 160.

The first and

second handle members

130 and 140 each define a

finger hole

130a and 140a, respectively, therethrough for receiving a finger of an operator.

Finger holes

130a and 140a facilitate movement of the first and

second handle members

130 and 140 relative to each other about “x” and “y” axes that are substantially orthogonal to each other and a longitudinal “z” axis. The first and

second handle members

130 and 140, in some embodiments, are each monolithically formed with its

respective shaft member

110 and 120. Alternatively, the first and

second handle members

130 and 140 may each be engaged with its

respective shaft member

110 and 120 in any suitable configuration, e.g., via mechanical engagement, molding, adhesion, etc.

As shown in FIG. 2, in conjunction with FIG. 1, the first and

second shaft members

110 and 120 intersect at

intersection portions

116 and 126, respectively. The

intersection portions

116 and 126 of the first and

second shaft members

110 and 120 define

openings

116a and 126a, respectively, therethrough, for receiving a pivot pin assembly 170 for coupling the first and

second shaft member

110 and 120 together.

An insulative shim 128 is disposed between the

intersection portions

116 and 126 of the first and

second shaft members

110 and 120. The insulative shim 128 is affixed to an inner surface 126b of the intersection portion 126 and defines an opening 128a therethrough that is aligned with the

openings

116a and 126a of the

intersection portions

116 and 126. The insulative shim 128 is configured to extend between the

intersection portions

116 and 126 of the first and

second shaft members

110 and 120 to electrically isolate the first and

second shaft members

110 and 120 from each other. The insulative shim 128 is formed from an electrically insulative material, such as a ceramic or plastic, and may be glued, brazed, or otherwise mechanically and/or chemically secured to the second shaft member 120, as is within the purview of those skilled in the art. Additionally or alternatively, the inner surface 126b of the intersection portion 126 of the second shaft member 120, or a portion thereof, may include an insulative coating, e.g., a ceramic coating.

Referring now to FIGS. 3A-3C, in conjunction with FIG. 2, the pivot pin assembly 170 includes a spring pin 172, an insulated washer 174, and a pin head 176. The spring pin 172 includes a body portion 172a including a flange 172b at a first end thereof and a tail portion 172c, which has a smaller diameter than the body portion 172a, extending from a second end of the body portion 172a. The flange 172b is positioned against the insulated washer 174, which is positioned within a recess defined in an outer surface of the second shaft member 120 (FIG. 5B) . Alternatively, the insulative washer 174 can be replaced by an insulative coating on the second shaft member 120. The body portion 172a extends through the

openings

126a and 128a defined in the intersection 126 of the second shaft member 120 and the insulative shim 128, and the tail portion 172c extends through an opening 176a defined in the pin head 176 which is positioned in the opening 116a of the intersection portion 116 of the first shaft member 110. The flange 172b is formed from a resilient material to permit deflection thereof upon movement of the first and

second shaft members

110 and 120. The spring pin 172 maintains pressure between the first and

second shaft members

110 and 120 which, in turn, aids in maintaining proper jaw alignment during the sealing and cutting functions of the forceps 100.

Referring now to FIGS. 4A and 4B, in conjunction with FIG. 1, the first and

second jaw members

150 and 160 extend distally from the

intersection portions

116 and 126 of the first and

second shaft members

110 and 120.

Proximal portions

150a and 160a of the first and

second jaw members

150 and 160 extend longitudinally from the

intersection portions

116 and 126 along the “z” axis and define a gap “G_J” therebetween.

Distal portions

150b and 160b of the first and

second jaw members

150 and 160 include first and second

tissue contacting surfaces

152 and 162, respectively, that are twisted (e.g., curved, curled, bent, or otherwise shaped) to distally extend longitudinally and laterally away fron the “z” axis and are configured to mate when in a first approximated position.

The first and second

tissue contacting surfaces

152 and 162 each include a

leading end portion

152a and 162a that is distal to a trailing

end portion

152b and 162b, and at least one shear edge along a

side edge

154 and 164 of the first and second

tissue contacting surfaces

152 and 162, respectively. In particular, as shown in FIG. 4A, the concave side edge 154 of first jaw member 150 may define a shear edge configuration, while the convex side edge 164 of second jaw member 160 may defines a shear edge configuration. The opposite sides, e.g., the convex side edge 154 of first jaw member 150 and the concave side edge 164 of second jaw member 160, may likewise define shear edge configurations or may define blunt, rounded configurations. The first and second

tissue contacting surfaces

152 and 162 have a complementary geometry such that when the first and

second jaw members

150 and 160 are in a first approximated position the first and second

tissue contacting surfaces

152 and 162 are opposed and aligned for tissue sealing (FIG. 5C) , and when in a second approximated position, the first and second

tissue contacting surfaces

152 and 162 diverge laterally with increased clearance at the

leading end portions

152a and 162a of the first and second

tissue contacting surfaces

152 and 162 for tissue cutting (FIG. 6C) .

The first and

second shaft members

110 and 120 are a pair of electrodes, formed from an electrically conductive material, e.g., a metal, such as a stainless steel, that are configured to conduct electrosurgical energy therethrough. An insulative coating, such as an insulative paint, is disposed over the forceps 100 except at the

tissue contacting surfaces

152 and 162 and the shear-edge configured side edges 154 and 164 of the first and

second jaw members

150 and 160, the insulative shim 128 and insulative washer 174, which are already formed from an electrically insulative material, and plug (s) (not shown) of the

cables

101 and 103 which are connectable to an electrosurgical energy source (not shown) .

In one method of using the electrosurgical forceps 100 of the present disclosure, the first and

second jaw members

150 and 160 of the forceps 100 are placed at a desired surgical site around desired tissue and/or vessel (s) . As shown in FIG. 1, in the open position, the first and

second jaw members

150 and 160 are spaced apart from each other， and are pivotable about the “x” axis. The first and

second jaw members

150 and 160 are moved into the first approximated position by moving at least one of the first and

second handle members

130 and 140 towards the other in the direction of arrows “A， ” such that at least one of the first and

second handle members

130 and 140 pivots about the pivot pin 170, and the first and

second handle members

130 and 140 are closed to a first approximated position to grasp tissue “T” between the first and

second jaw members

150 and 160 as shown in FIG. 5A-5C. In the first approximated position， a distal gap “G_D” is opened between the insulative shim 128 and the intersection portion 116 of the first shaft member 110 and a proximal gap “G_P” is closed. The

distal portions

150b and 160b of the first and

second jaw members

150 and 160 grasp tissue “T” therebetween while the tissue around the boundary of the grasped tissue “T” is freely disposed within the gap “G_J” defined between the

proximal portions

150a and 150b of the first and

second jaw members

150 and 160.

With the

cables

101 and 103 of the forceps 100 connected to an electrosurgical energy source (not shown) , the electrosurgical energy source may then be activated to apply electrosurgical energy to the tissue “T” grasped between the first and second

tissue contacting surfaces

152 and 162 of the first and

second jaw members

150 and 160 to seal the tissue “T， ” while the boundary tissue disposed within the gap “G_J” defined between the

proximal portions

150a and 160a of the first and

second jaw members

150 and 160 is not grasped or subjected to electrosurgical energy.

When sealing is complete and the electrosurgical energy source (not shown) is shut off, the first and

second handle members

130 and 140 may be returned to the open position to release tissue “T” held between the first and second

tissue contacting surfaces

152 and 162 of the first and

second jaw members

150 and 160, or the first and

second jaw members

150 and 160 may be moved to a second approximated position to cut the tissue “T” disposed therebetween.

As shown in FIGS. 6A-6C, to move to the second approximated position, the second handle member 140 is moved laterally in the direction of arrow “B， ” so that the second handle member 140 is yawed around the y-axis. When rotated about the “y” axis， the distal gap “G_D” between the

intersection portions

116 and 126 of the first and

second shaft members

110 and 120 is closed and the proximal gap “G_P” is opened. At the same time, the first and

second jaw members

150 and 160 are laterally displaced relative to each other. When this lateral movement between the first and

second jaw members

150 and 160 is larger than the width of the first and

second jaw members

150 and 160, the shear-edge configured side edges 154 and 164 of the first and

second jaws

150 and 160 cut the tissue “T” bound between the first and

second jaw members

150 and 160， and the boundary tissue disposed within the gap “G_J” defined between the

proximal portions

150a and 160a of the first and

second jaw members

150 and 160 is not cut. The first and

second handle members

130 and 140 may then be returned to the open position. As shown in FIGS. 7A-7C, in the example method described above, a vessel “V” may be sealed “S” and cut “C” without affecting the tissue “T” surrounding the vessel “V” .

Turning now to FIGS. 8A and 8B, an electrosurgical instrument 2 including a forceps 100' and a connector assembly 200 in accordance with another embodiment of the present disclosure is shown. The forceps 100' includes a first elongated shaft member 110' pivotably connected to a second elongated shaft member 120' via the pivot pin assembly 170. The first shaft member 110' includes a first handle member 130' ， an intersection portion 116， and a first jaw member 150' . The second shaft member 120' includes a second handle member 140' ， an intersection portion 126， and a second jaw member 160' .

The first and second handle members 130' and 140' each define a

finger hole

130a and 140a, respectively. The first handle members 130' includes a raised rail 132 and optionally a proximally extending tail 134 that are configured to mate with the connector assembly 200. The second handle member 140' includes a bump stopper 142 disposed on an inner surface 140a of the second handle member 140' that extends towards the first handle member 130' .

The connector assembly 200 includes a housing 202 including a lower surface 202a configured to matingly engage the raised rail 132 and optionally, the tail 134 of the first handle member 130' , an upper surface 202b including a switch 204 extending outwardly towards the second handle member 140' and in general alignment with the bump stopper 142, and a proximal end including a cable 206 extending therefrom and terminating at a plug 208 for electrically connecting the forceps 100' to an electrosurgical energy source (not shown) .

As shown in FIG. 9, in conjunction with FIG. 8A, the first and second jaw members 150' and 160' include proximal portions 150a' and 160a' that extend longitudinally from the

intersection portions

116 and 126 of the first and second shaft members 110' and 120' and define a gap “G_J” therebetween. Distal portions 150b' and 160b' include first and second tissue contacting surfaces 152' and 162' that define side edges 154' , 164' , wherein at least one side edge 154' , 164' of each of the first and second tissue contacting surfaces 152' and 162' defines a shear-edge configuration, e.g., the convex side edge 154' of first tissue contacting surface 152' of first jaw member 150' and the concave side edge 164' of second tissue contacting surface 162' of second jaw member 160' . The tissue contacting surfaces 152' and 162' and the shear-edge configured side edges 154' and 164' are substantially similar to those described above with respect to the forceps 100, however, in this embodiment, a substantially triangularly-shaped gap “G_T” is defined along the tissue contacting surfaces 152' and 154' from a leading end 152a' and 162a' to a trailing end 152b' and 162b' , respectively.

The leading ends 152a' and 162a' of the first and second jaw members 150' and 160' are contoured and complementary in shape to aid in alignment of the first and second jaw members 150' and 160' . As shown, the leading end 152a' of the first jaw member 150' includes a substantially v-shaped convex surface 156 and the leading end 162a' of the second jaw member 160' includes a substantially v-shaped concave surface 166. The complementary geometry of the leading ends 152a' and 162a' of the first and second jaw members 150' and 160' aids in maintaining proper jaw alignment during the sealing and cutting functions of the forceps 100 and reduces the cutting force necessary to cut tissue.

The first and second shaft members 110' and 120' are a pair of electrodes, similar to the first and

second shaft members

110 and 120 of the forceps 100. Accordingly, an insulative coating is disposed over the forceps 100' , including the

surfaces

156 and 166 at the leading end portions 152a' and 162a' of the first and

second jaw members

150' and 160. The forceps 100' is free of insulative coating at the tissue contacting surfaces 152' and 162' and the shear-edge configured side edges 154' and 164' of the first and second jaw members 150' and 160' , the plug 208, as well as the insulative shim 128 and the insulative washer 174, as described above. Additionally, the raised rail 132 and/or tail 134 of the first handle member 130' may be free of insulative coating for electrical connection with electrical contacts disposed within the connector assembly 200.

In one method of using the electrosurgical instrument 2, the connector assembly 200 is assembled onto the forceps 100' , as shown in FIG. 10, and the first and second jaw members 150' and 160' are positioned around desired tissue and/or vessel (s) at a desired surgical site and moved into the first approximated position by latching the first and second handle members 130' and 140' together to grasp tissue “T” therebetween. The tissue contacting surfaces 152' and 162' (FIG. 9) of the first and second jaw members 150' and 160' are substantially opposed and paralleled under the sealing force, and the bump stopper 142 contacts the switch 204 of the connector assembly 200 to apply electrosurgical energy to tissue “T” grasped between the first and second tissue contacting surfaces 152' and 162' of the first and second jaw members 150' and 160' , while the boundary tissue “T_B” disposed within the gap “G_J” is freely disposed within the proximal portions 150a' and 160a' of the first and second jaw members 150' and 160' .

When sealing is complete, the first and second handle members 130' and 140' may be returned to an open position to release tissue “T” held between the first and second tissue contacting surfaces 152' and 162' of the first and second jaw members 150' and 160' , or the first and second jaw members 150' and 160' may be moved to a second approximated position to cut the tissue “T” disposed therebetween.

As shown in FIGS. 11A-11D, in conjunction with FIG. 10, to move to the second approximated position, the pressure applied to the first and second handle members 130' and 140' during sealing is relaxed to restore the triangular gap “G_T” between the first and second jaw members 150' and 160' (FIG. 11A) ， and to disengage the bump stopper 142 from the switch 204 (FIG. 10) to stop the application of electrosurgical energy. The second handle member 140' is moved related to the first handle member 130' about the “y” axis such that the convex and

concave surfaces

156 and 166 of the first and second jaw members 150' and 160' slide relative to each other until an apex 156a of the convex surface 156 contacts an outer edge 166a of the concave surface 166 (FIG. 11 B) and then falls under the residual pressure between the first and second jaw members 150' and 160' (FIG. 11C) such that convex and

concave surfaces

156 and 166 become laterally offset with respect to each other. As the second jaw member 160' is elastically yawed， a stable lateral pressure is obtained between the first and second jaw members 150' and 160' . The first and second handle members 130' and 140' are latched again by rotating the first and/or second handle members 130' and 140' about the “x” axis to cut the tissue disposed between the first and second tissue contacting surfaces 152' and 162' from the leading end 152a' and 162a' to the trailing end 152b' and 162b' via the shear-edge configured side edges 154' and 164' (FIG. 11D) . The first and second handle members 130' and 140' may then be release and moved back to the open position.

The embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery. ” Such systems employ various robotic elements to assist the operator and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the operator during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep a subject (e.g., a patient) for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc. ) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument (s) .

The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles 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.

As shown in FIG. 12, a medical work station is shown generally as work station 1000 and generally may include a plurality of

robot arms

1002 and 1003； a control device 1004； and an operating console 1005 coupled with control device 1004. Operating console 1005 may include a display device 1006, which may be set up in particular to display three-dimensional images； and

manual input devices

1007 and 1008, by means of which an operator (not shown) , for example a surgeon, may be able to telemanipulate

robot arms

1002 and 1003 in a first operating mode.

Each of the

robot arms

1002 and 1003 may include a plurality of members, which are connected through joints, and an attaching

device

1009 and 1011, to which may be attached， for example， a surgical tool “ST” supporting an end effector 1100， in accordance with any one of several embodiments disclosed herein, as will be described in greater detail below.

Robot arms

1002 and 1003 may be driven by electric drives (not shown) that are connected to control device 1004. Control device 1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that

robot arms

1002 and 1003, their attaching

devices

1009 and 1011 and thus the surgical tool (including end effector 1100) execute a desired movement according to a movement defined by means of

manual input devices

1007 and 1008. Control device 1004 may also be set up in such a way that it regulates the movement of

robot arms

1002 and 1003, and/or of the drives.

Medical work station 1000 may be configured for use on a patient 1013 lying on a patient table 1012 to be treated in a minimally invasive manner by means of end effector 1100. Medical work station 1000 may also include more than two

robot arms

1002 and 1003, the additional robot arms likewise being connected to control device 1004 and being telemanipulatable by means of operating console 1005. A medical instrument or surgical tool (including an end effector 1100) may also be attached to the additional robot arm. Medical work station 1000 may include a database 1014, in particular coupled to control device 1004, in which are stored, for example, pre-operative data from patient/living being 1013 and/or anatomical atlases.

While several embodiments of the disclosure have been shown in the drawings and described herein, it is not intended that the disclosure 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. Therefore, the above description should not be construed as limiting, but merely as examples of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

Claims

An electrosurgical instrument comprising:

an end effector having first and second jaw members disposed about a longitudinal axis, the first jaw member including a proximal portion and a distal portion having a first tissue contacting surface, and the second jaw member including a proximal portion and a distal portion having a second tissue contacting surface, the proximal portions of the first and second jaw members defining a gap therebetween and the distal portions of the first and second jaw members including shear edges at opposed sides of the first and second tissue contacting surfaces, the end effector configured to selectively communicate electrosurgical energy between the first and second tissue contacting surfaces of the first and second jaw members upon actuation thereof, at least one of the first and second jaw members movable relative to the other between an open position, a first approximated position in which the first and second tissue contacting surfaces are substantially opposed to each other, and a second approximated position in which the first and second tissue contacting surfaces are laterally offset with respect to each other.
The electrosurgical instrument according to claim 1, wherein the proximal portions of the first and second jaw members extend along the longitudinal axis and the distal portions are longitudinally and laterally twisted with respect to the longitudinal axis.
The electrosurgical instrument according to claim 1, wherein the first and second tissue contacting surfaces define a triangular-shaped gap therebetween when in the first approximated position.
The electrosurgical instrument according to claim 1, wherein the distal portions of the first and second jaw members include complementary-shaped leading ends that have a different geometry from that of the first and second tissue contacting surfaces.
The electrosurgical instrument according to claim 4, wherein one of the complementary-shaped leading ends includes a protuberance and one of the complementary-shaped leading ends includes a recessed surface.
The electrosurgical instrument according to claim 4, wherein the leading end of the first jaw member includes a convex surface and the leading end of the second jaw member includes a concave surface.
The electrosurgical instrument according to claim 4, wherein the complementary-shaped leading ends are configured to mate when in the first approximated position.
The electrosurgical instrument according to claim 4, wherein the complementary-shaped leading ends are laterally offset with respect to one another when in the second approximated position.
An electrosurgical instrument comprising:

an end effector having first and second jaw members disposed about a longitudinal axis, the first jaw member defining a first tissue contacting surface and the second jaw member defining a second tissue contacting surface, at least one of the first and second jaw members movable relative to the other between an open position, a first approximated position in which the first and second tissue contacting surfaces are substantially opposed to each other, and a second approximated position in which the first and second tissue contacting surfaces are laterally offset with respect to each other； and

first and second shaft members that cooperate to define the end effector, the first jaw member disposed on a distal end portion of the first shaft member and the second jaw member disposed on a distal end portion of the second shaft member, the first and second shaft members coupled together by a pivot pin assembly extending through openings defined in respective intersection portions of the first and second shaft members, at least one of the first and second shaft members pivotable with respect to the other of the first and second shaft members about two different axes that are substantially orthogonal to each other and the longitudinal axis so as to permit movement of the at least one of the first and second jaw members between the open position, the first approximated position, and the second approximated position.
The electrosurgical instrument according to claim 9, wherein the pivot pin assembly includes a spring pin and a pin head, the spring pin having a body portion, a resilient flange disposed at a first end of the body portion, and a tail portion extending from a second end of the body portion and into an opening defined in the pin head.
The electrosurgical instrument according to claim 10, wherein the flange is positioned against the second shaft member and the pin head is positioned in the opening of the intersection portion of the first shaft member.
The electrosurgical instrument according to claim 10, wherein when the first and second shaft members are in the first approximated position a distal gap is opened between the intersection portions of the first and second shaft members and a proximal gap defined between the intersection portions is closed.
The electrosurgical instrument according to claim 10, wherein when the first and second shaft members are in the second approximated position, a proximal gap is opened between the intersection portions of the first and second shaft members and a distal gap defined between the intersection portions is closed.
The electrosurgical instrument according to claim 9, wherein proximal end portions of the first and second shaft members include first and second handle members, respectively.
The electrosurgical instrument according to claim 14, wherein the first handle member includes a raised rail and the second handle member includes a bump stopper.
The electrosurgical instrument according to claim 15, further comprising a connector assembly releasably engaged with the raised rail of the first handle member.
The electrosurgical instrument according to claim 16, wherein the bump stopper engages a switch disposed in the connector assembly when the first and second shaft members are in the first approximated position.