WO2017190302A1 - Dispositif laparoscopique de suture et division de vaisseau - Google Patents

Dispositif laparoscopique de suture et division de vaisseau Download PDF

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Publication number
WO2017190302A1
WO2017190302A1 PCT/CN2016/081087 CN2016081087W WO2017190302A1 WO 2017190302 A1 WO2017190302 A1 WO 2017190302A1 CN 2016081087 W CN2016081087 W CN 2016081087W WO 2017190302 A1 WO2017190302 A1 WO 2017190302A1
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WO
WIPO (PCT)
Prior art keywords
handle
movable handle
drive member
electrosurgical forceps
movement
Prior art date
Application number
PCT/CN2016/081087
Other languages
English (en)
Inventor
Weijiang Ding
Mingfeng Xu
Original Assignee
Covidien Lp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covidien Lp filed Critical Covidien Lp
Priority to CN201680085366.0A priority Critical patent/CN109069199B/zh
Priority to PCT/CN2016/081087 priority patent/WO2017190302A1/fr
Publication of WO2017190302A1 publication Critical patent/WO2017190302A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/291—Handles the position of the handle being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2919—Handles transmission of forces to actuating rod or piston details of linkages or pivot points
    • A61B2017/292—Handles transmission of forces to actuating rod or piston details of linkages or pivot points connection of actuating rod to handle, e.g. ball end in recess
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2947—Pivots

Definitions

  • the present disclosure relates to energy-based surgical instruments and, more particularly, to energy-based surgical forceps configured for sealing and cutting tissue.
  • a forceps or hemostat is an instrument which relies on mechanical action between its jaws to grasp, clamp, and constrict tissue and/or vessels.
  • Open forceps are commonly used in open surgical procedures, whereas “endoscopic forceps” or “laparoscopic forceps” are used for less invasive or minimally invasive surgical procedures.
  • Electrosurgical or 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.
  • the present disclosure is directed to energy-based surgical instruments having movable, opposed jaw members that are configured for grasping, sealing, dividing, and releasing tissue and/or vessel (s) using a two-step handle movement.
  • the two-step handle movement allows an operator to grasp, seal, divide, and release tissue quickly and efficiently, and can reduce the likelihood of bleeding which can interrupt a surgical procedure.
  • an electrosurgical forceps includes a handle assembly having a movable handle pivotably connected to a fixed handle, an elongated shaft extending distally from the fixed handle, an end effector disposed at a distal end of the elongated shaft, and a drive member slidably disposed within the elongated shaft.
  • the drive member includes a proximal end pivotably coupled to the movable handle and a distal end operably coupled to the end effector.
  • a first movement of the movable handle relative to the fixed handle causes a first distal movement of the drive member to effect a first function of the end effector, and a second movement of the movable handle relative to the fixed handle causes a second distal movement of the drive member to effect a second function of the end effector.
  • a cross pin interconnects the movable handle and the fixed handle.
  • the cross pin may include a first pin portion extending along a first axis, and a second pin portion intersecting the first pin portion and extending along a second axis.
  • the first movement of the movable handle may be rotation about the second pin portion, and the second movement of the movable handle may be rotation about the first pin portion.
  • the cross pin is disposed within a proximal recess of a connector of the movable handle, with the first pin portion rotatably disposed within opposed openings defined in the connector, and the connector is disposed within a coupler of the fixed handle, with the second pin portion rotatably disposed within opposed openings defined in first and second walls of the coupler, such that the movable handle is rotatable about the first and second pin portions.
  • the first wall of the coupler of the fixed handle may include a sloped inner wall and the second wall of the coupler may include a substantially planar wall portion such that the movable handle is rotatable about the second pin portion within a range defined by the sloped inner wall and the substantially planar wall portion.
  • a ball rod interconnects the movable handle and the drive member.
  • the ball rod may include a rod body having first and second balls disposed at opposed ends thereof.
  • the first ball may be securely retained and rotatable within a distal recess defined in a connector of the movable handle, and/or the second ball may be securely retained and rotatable within a socket defined in the proximal end of the drive member.
  • the rod body extends through an opening defined in the connector of the movable handle.
  • the first movement of the movable handle may move the rod body from an upper portion to a lower portion of the opening defined in the connector of the movable handle to drive the drive member to a first distal position
  • the second movement of the movable handle may move the rod body laterally within the lower portion of the opening defined in the connector of the movable handle to drive the drive member to a second distal position.
  • the end effector includes first and second jaw members pivotably coupled to each other.
  • the first function of the end effector may be closing of the first and second jaw members to a sealing position, and/or the second function of the end effector may be closing of the first and second jaw members to a cutting position.
  • a method of treating tissue includes: positioning first and second jaw members of an electrosurgical forceps at a surgical site, the electrosurgical forceps including a handle assembly having a movable handle pivotably connected to a fixed handle, an elongated shaft extending distally from the fixed handle, and a drive member slidably disposed within the elongated shaft, the drive member including a proximal end pivotably coupled to the movable handle and a distal end operably coupled to the first and second jaw members; moving the movable handle relative to the fixed handle to cause a first distal movement of the drive member to close the first and second jaw members and grasp tissue therebetween; applying electrosurgical energy to the tissue grasped between the first and second jaw members to seal the tissue; and moving the movable handle relative to the fixed handle to cause a second distal movement of the drive member to further close the first and second jaw members and cut the tissue disposed therebetween.
  • the method may further include moving the movable handle member relative to the fixed handle to
  • FIG. 1 is a side, perspective view of an energy-based surgical system including a forceps connected to a source of electrosurgical energy in accordance with the present disclosure
  • FIG. 2 is a side, perspective view of a handle assembly of the forceps of FIG. 1;
  • FIG. 3 is a side, exploded perspective view of the handle assembly of FIG. 2, with parts separated;
  • FIG. 4A is a side, perspective view of a fixed handle of the handle assembly of FIG. 3;
  • FIG. 4B is an enlarged, perspective view of a portion of the fixed handle of FIG. 4A, shown along the area of detail 4B identified in FIG. 4A;
  • FIG. 5A is a side, perspective view of a handle assembly of the forceps of FIG. 1, shown in an open position;
  • FIG. 5B is an enlarged, perspective view of a portion of the handle assembly of FIG. 5A, shown along the area of detail 5B identified in FIG. 5A;
  • FIG. 6 is a side view of the handle assembly of FIG. 5A;
  • FIG. 7A is a rear end view of the handle assembly of FIG. 5A;
  • FIG. 7B is an enlarged, end view of a portion of the handle assembly of FIG. 7A, shown along the area of detail 7B identified in FIG. 7A;
  • FIG. 8 is a top view of the handle assembly of FIG. 5A;
  • FIG. 9A is a side, perspective view of a handle assembly of the forceps of FIG. 1, shown in a sealing position;
  • FIG. 9B is an enlarged, perspective view of a portion of the handle assembly of FIG. 9A, shown along the area of detail 9B identified in FIG. 9A;
  • FIG. 10A is a side view of the handle assembly of FIG. 9A;
  • FIG. 10B is an enlarged, side view of a portion of the handle assembly of FIG. 10A, shown along the area of detail 10B identified in FIG. 10A;
  • FIG. 11A is a rear end view of the handle assembly of FIG. 9A;
  • FIG. 11B is an enlarged, end view of a portion of the handle assembly of FIG. 11A, shown along the area of detail 11B identified in FIG. 11A;
  • FIG. 12 is a top view of the handle assembly of FIG. 9A;
  • FIG. 13A is a side, perspective view of a handle assembly of the forceps of FIG. 1, shown in a cutting position;
  • FIG. 13B is an enlarged, perspective view of a portion of the handle assembly of FIG. 13A, shown along the area of detail 13B identified in FIG. 13A;
  • FIG. 14 is a side view of the handle assembly of FIG. 13A;
  • FIG. 15A is a rear end view of the handle assembly of FIG. 13A;
  • FIG. 15B is an enlarged, end view of a portion of the handle assembly of FIG. 15A, shown along the area of detail 15B identified in FIG. 15A;
  • FIG. 16 is a top view of the handle assembly of FIG. 13A.
  • FIG. 17 is a schematic illustration of a work station configured for use with a forceps of the present disclosure.
  • proximal refers to a portion of a structure closer to an operator
  • distal refers to a portion of the same structure further from the operator.
  • subject refers to a human patient or animal.
  • doctor refers to a doctor (e.g., a surgeon) , a nurse, and other clinicians or care providers, and may include support personnel.
  • Directional reference terms, such as “upper” and “lower, ” and the like, are intended to ease description of the embodiments and are not intended to have any limiting effect on the ultimate orientations of the surgical instruments, or any parts thereof.
  • an energy-based surgical system 10 in accordance with the present disclosure is configured for grasping, electrically sealing, and mechanically cutting/dividing/dissecting tissue and/or vessel (s) in endoscopic or laparoscopic surgical procedures.
  • the energy-based surgical system 10 includes a forceps 100 releasably connected to a source of electrosurgical energy 200 via cable 202.
  • the forceps 100 includes a handle assembly 110, an elongated shaft 112 extending distally from the handle assembly 110, and an end effector 114 disposed at a distal end of the elongated shaft 112.
  • the elongated shaft 112 extends along a longitudinal axis “X” and includes a longitudinal opening 112a defined therethrough for slidable receipt of a drive member 116 therein.
  • the end effector 114 is operably coupled to the drive member 116 and includes first and second jaw members 114a, 114b pivotably coupled, in opposed relation, to each other, that are configured to grasp, seal, cut, and/or dissect tissue therebetween.
  • a drive pin 118 extends through opposed slots 115 defined in the first and second jaw members 114a, 114b such that longitudinal movement of the drive member 116, with respect to the elongated shaft 112, causes the drive pin 118 to travel through the slots 115 of the first and second jaw members 114a, 114b to effect a function of the end effector 114, e.g., opening or closing of the first and second jaw members 114a, 114b relative to each other, as described in further detail below.
  • the handle assembly 110 includes a movable handle 120 and a fixed handle 140.
  • the movable handle 120 is pivotably coupled to the fixed handle 140 by a cross pin 160 (FIG. 3) , and is pivotably coupled to the drive member 116 (FIG. 1) via a ball rod 170 (FIG. 3) .
  • an upper portion 120a of the movable handle 120 includes a connector 122
  • a lower portion 120b of the movable handle 120 includes a movable handle member 124.
  • the connector 122 of the movable handle 120 includes a body portion 122a defining a proximal recess 122b between upper and lower legs 125a, 125b extending proximally from the body portion 122a of the connector 122.
  • Each of the upper and lower legs 125a, 125b defines an opening 125c therethrough.
  • the cross pin 160 includes a first pin portion 162 extending along a first axis, “Y, ” and a second pin portion 164 extending along a second axis, “Z, ” that intersects and is perpendicular to the first axis, “Y. ”
  • the cross pin 160 is positioned within the proximal recess 122b of the connector 122 with the first pin portion 162 extending through the openings 125c defined in the upper and lower legs 125a, 125b of the connector 122 such that the movable handle 120 is rotatable, as indicated by arrow “Y 1 , ” about the first axis, “Y. ”
  • the connector 122 includes a distal recess 122c defined between a cover 126 that is releasably connected to a distal end 122d of the body portion 122a of the connector 122.
  • the ball rod 170 includes a rod body 172 including first and second balls 174, 176 disposed at opposed ends of the rod body 172.
  • the distal recess 122c of the connector 122 has a substantially spherical shape to rotatably retain the first ball 174 of the ball rod 170 therein.
  • the rod body 172 of the ball rod 170 extends through an opening 123 (see e.g., FIG. 2) defined by a perimeter formed by the cover 126 and the distal end 122d of the connector 122. As shown in FIGS.
  • the second ball 176 of the ball rod 170 is disposed within a socket 116a defined in a proximal end of the drive member 116.
  • the second ball 176 of the ball rod 170 is secured within the socket 116a of the drive member 116, and is configured to rotate within the socket 116a and to move (e.g., push or pull) the drive member 116 along the longitudinal axis “X. ”
  • an upper portion 140a of the fixed handle 140 includes a housing assembly 142, and a lower portion 140b of the fixed handle 140 includes a fixed handle member 144.
  • the housing assembly 142 includes a substantially cylindrical body 146 defining a bore 146a therethrough through which the drive member 116 (FIG. 1) is slidably disposed.
  • a distal end 146b of the cylindrical body 146 includes a knob 148 rotatable about the cylindrical body 146. As shown, for example, in FIG. 8, in conjunction with FIG. 1, the knob 148 includes a proximal portion 148a and a distal portion 148b connected together via thread 148c.
  • a proximal pin 149a extends through the proximal portion 148a of the knob 148 and through a cylindrical slot (not shown) of the cylindrical body 146, such that rotation of the drive member 116 causes a corresponding rotation of the proximal portion 148a of the knob 148, and vice versa.
  • a distal pin 149b extends through the distal portion 148b of the knob 148 and into operative engagement with the elongated shaft 112, such that rotation of the distal portion 148b of the knob 148 results in a rotation of the first and second jaw members 114a, 114b about longitudinal axis “X. ” .
  • An extension 150 extends proximally from the cylindrical body 146 of the housing assembly 142.
  • the extension 150 includes a coupler 152 disposed at a proximal end thereof.
  • the coupler 152 includes a body portion 152a defining a recess 152b therein, the recess 152b is partially defined by first and second walls 154, 156 of the coupler 152.
  • the recess 152b is dimensioned to receive a proximal portion of the connector 122 of the movable handle 120.
  • the first and second walls 154, 156 include openings 154a, 156a, respectively, defined therethrough that are configured to receive the second pin portion 164 of the cross pin 160 such that the movable handle 120 is rotatable, as indicated by arrow “Z 1 , ” about the second axis, “Z. ”
  • the first wall 154 includes a sloped inner wall 154b and the second wall 156 includes a substantially planar inner wall portion 156b such that the movable handle 120 is rotatable relative to the fixed handle 140 about the first axis, “Y” (FIG. 3) , in the limited range defined between the substantially planar wall portion 156b and the sloped inner wall 154b of the coupler 152 of the fixed handle 140.
  • the movable and fixed handle members 124, 144 of the movable and fixed handles 120, 140 are configured to allow an operator to effect movement of the movable handle 120 relative to the fixed handle 140.
  • the movable and fixed handle members 124, 144 each define a finger hole 124a, 144a, respectively, therethrough for receiving a finger of an operator.
  • the movable and fixed handle members 124, 144 are each monolithically formed with its respective movable and fixed handle 120, 140.
  • the movable and fixed handle members 124, 144 may each be engaged with its respective movable and fixed handle 120, 140 in any suitable configuration, e.g., via mechanical engagement, molding, adhesion, etc.
  • the movable handle member 124 includes a first guide member 128 extending from an inner surface 124b of the movable handle member 124 towards the fixed handle member 144, and the fixed handle member 144 includes a second guide member 158 extending from an inner surface 144b of the fixed handle member 144 towards the movable handle member 124.
  • the first and second guide members 128, 158 have a general L-shaped configuration including respective body portions 128a, 158a and respective leg portions 128b, 158b extending substantially perpendicularly from the body portions 128a, 158a.
  • the leg portions 128b, 158b include substantially flat inner surfaces 128c, 158c, and convex outer surfaces 128d, 158d, respectively.
  • the movable and fixed handle members 124, 144 of the movable and fixed handles 120, 140 are spaced from each other.
  • the drive member 116 is disposed in a proximal-most position with the first and second jaw members 114a, 114b of the end effector 14 open and in spaced relation relative to each other. As shown in FIGS.
  • the first ball 174 of the ball rod 170 is rotated such that the rod body 172 extends distally upwards through an upper portion 123a of opening 123 defined in the connector 122 of the movable handle 120 towards the drive member 116 (FIG. 1) at about a 90° angle, “ ⁇ , ” with respect to the body portion 122a of the connector 122 of the movable handle 120.
  • the dimension of the upper portion 123a of the opening 123 limits the rotation of the movable handle 120 about the first axis, “Y” (FIG. 3) . As shown in FIG.
  • the first ball 174 of the ball rod 170 rotates within the connector 122 of the movable handle 120 such that the rod body 172 extends through a lower portion 123b of the opening 123 defined in the connector 122 (see e.g., FIG. 9B) .
  • the second ball 176 of the ball rod 170 rotates within the socket 116a of the drive member 116 (FIG. 1) such that the rod body 172 extends distally along longitudinal axis “X” at about a 180° angle “ ⁇ ” (FIG.
  • the operator moves the movable handle member 124 laterally, in the direction of arrow B, to rotate the movable handle 120 about the first pin portion 162 of the cross pin 160 about the first axis, “Y” (FIG. 3) , until the connector 122 of the movable handle 120 contacts the sloped inner wall 154b of the coupler 152 of the fixed handle 140 (see e.g., FIG. 4B) .
  • FIGS. 13A-16 as the movable handle 120 is rotated laterally with respect to the fixed handle 140, the first ball 174 of the ball rod 170 rotates within the connector 122 of the movable handle 120 such that the rod body 172 moves laterally within the lower portion 123b of the opening 123 defined in the connector 122 (see e.g., FIG. 13B) which, in turn, drives the rod body 172 distally such that the second ball 176 rotates and drives the drive member 116 (FIG. 1) distally to a second distal position, which in turn, causes distal movement of the drive pin 118 (FIG.
  • cutting motion is completed and the movable and fixed handle members 120, 140 return to the open position of FIG. 1 to reset the forceps 100. Accordingly, cutting with the forceps is defined by one continuous motion following a generally L-shaped path, so that cutting and resetting merge as one action.
  • the forceps 100 is placed at a desired surgical site and the first and second jaw members 114a, 114b are positioned in an open position around desired tissue and/or vessel (s) (not shown) .
  • desired tissue and/or vessel not shown
  • the movable and fixed handle members 124, 144 of the movable and fixed handles 120, 140 are spaced apart from each other.
  • the handle assembly 110 is moved to a sealing position by moving the movable handle member 124 towards the fixed handle member 144, in the direction of arrow “A” shown in FIG. 8, such that the ball rod 170 is moved to an extended position, as shown, for example, in FIG. 10A, thereby driving the drive member 116 (FIG. 1) distally to effect a first function of the end effector 114 (FIG. 1) , e.g., closing the first and second jaw members 114a, 114b (FIG. 1) to grasp tissue therebetween.
  • the source of electrosurgical energy 200 (FIG. 1) may then be activated to apply electrosurgical energy to tissue grasped between the first and second jaw members 114a, 114b of the end effector 114.
  • the handle assembly 110 may be returned to the open position (FIG. 1) to release tissue held between the first and second jaw members 114a, 114b, or the handle assembly 110 may be moved to a cutting position to cut the sealed tissue disposed between the first and second jaw members 114a, 114b.
  • the movable handle member 124 is moved laterally with respect to the fixed handle member 144, as shown for example, in FIG. 12, in the direction of arrow “B, ” such that the ball rod 170 is moved to a further extended position, thereby further driving the drive member 116 (FIG. 1) distally to effect a second function of the end effector 114 (FIG. 1) , e.g., staggering the first and second jaw members at an angle with respect to each other to cut tissue disposed therebetween.
  • the movable handle member 124 is then moved proximally in the direction of arrow “C, ” shown in FIG. 16, to complete the cutting motion, thereby releasing the sealed and divided tissue, and re-setting the forceps 100 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.
  • 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.
  • 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.
  • 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 the embodiments disclosed herein.
  • 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
  • Control device 1004 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 with control device 1004, in which are stored, for example, pre-operative data from patient/living being 1013 and/or anatomical atlases.

Abstract

L'invention concerne une pince électrochirurgicale comprenant un ensemble poignée comportant une poignée mobile reliée pivotante à une poignée fixe, un arbre allongé s'étendant de manière distale à partir de la poignée fixe, un effecteur terminal disposé à une extrémité distale de l'arbre allongé, et un élément d'entraînement disposé coulissant à l'intérieur de l'arbre allongé. L'élément d'entraînement comprend une extrémité proximale accouplée pivotante à la poignée mobile et une extrémité distale accouplée fonctionnellement à l'effecteur d'extrémité. Un premier déplacement de la poignée mobile par rapport à la poignée distale entraîne un premier déplacement distal de l'élément d'entraînement pour effectuer une première fonction de l'effecteur terminal, et un second déplacement de la poignée mobile par rapport à la poignée fixe entraîne un second déplacement distal de l'élément d'entraînement pour effectuer une seconde fonction de l'effecteur terminal.
PCT/CN2016/081087 2016-05-05 2016-05-05 Dispositif laparoscopique de suture et division de vaisseau WO2017190302A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CN201680085366.0A CN109069199B (zh) 2016-05-05 2016-05-05 血管密封和离断腹腔镜式装置
PCT/CN2016/081087 WO2017190302A1 (fr) 2016-05-05 2016-05-05 Dispositif laparoscopique de suture et division de vaisseau

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CN2016/081087 WO2017190302A1 (fr) 2016-05-05 2016-05-05 Dispositif laparoscopique de suture et division de vaisseau

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WO2017190302A1 true WO2017190302A1 (fr) 2017-11-09

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CN102119010A (zh) * 2008-08-07 2011-07-06 索格尔克斯公司 具有切割头的电外科器械钳口结构
CN103211647A (zh) * 2012-01-23 2013-07-24 科维蒂恩有限合伙公司 电外科仪器以及制造所述电外科仪器的方法
CN204106126U (zh) * 2014-07-14 2015-01-21 华侨大学 一种压电式测力的外科手术夹钳

Patent Citations (4)

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Publication number Priority date Publication date Assignee Title
US7232440B2 (en) * 2003-11-17 2007-06-19 Sherwood Services Ag Bipolar forceps having monopolar extension
CN102119010A (zh) * 2008-08-07 2011-07-06 索格尔克斯公司 具有切割头的电外科器械钳口结构
CN103211647A (zh) * 2012-01-23 2013-07-24 科维蒂恩有限合伙公司 电外科仪器以及制造所述电外科仪器的方法
CN204106126U (zh) * 2014-07-14 2015-01-21 华侨大学 一种压电式测力的外科手术夹钳

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