CA1290216C - Rotatable surgical snare - Google Patents
Rotatable surgical snareInfo
- Publication number
- CA1290216C CA1290216C CA000536761A CA536761A CA1290216C CA 1290216 C CA1290216 C CA 1290216C CA 000536761 A CA000536761 A CA 000536761A CA 536761 A CA536761 A CA 536761A CA 1290216 C CA1290216 C CA 1290216C
- Authority
- CA
- Canada
- Prior art keywords
- snare
- cable
- actuator
- recess
- rotating member
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Classifications
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/32056—Surgical snare instruments
-
- 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
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1407—Loop
Abstract
Rotatable Surgical Snare Abstract The invention provides an improved surgical snare having an operating cable freely rotatable while the handle is maintained steady, having a rotating assembly mounted in the handle so that the axis of rotation of the assembly is essentially coaxial with the longitudinal axis of the handle and having a quick disconnect-connect means for attaching the operating cable to the rotating assembly without external clamping means.
Description
~290216 10-456 Description Rotatable Surqical Snare Technical Field This invention relates generally to surgical snares and, more particularly, to an improved rotatable surgical snare for endoscopic polypectomy use.
Background Art Polypectomes for surgically removing colonic polyps usually comprise an electrocautery snare retractable into a long flexible sheath by means of an electrically conducting cable and a handle connected to the sheath and operating cable for retracting and protracting the snare and for connection to a source of electric power.
In use, the polypectome with the snare retracted is positioned near a polyp with the aid of an endoscope.
Once the polyp is locatèd, the operator employes the handle to protract the snare to its open position. The snare, however, rarely protracts from the sheath ideally positioned to engage the polyp; the operator must manipulate the entire handle in order to rotate the snare. Since the handle has an electrical connection, it is not uncommon for the connection to become entangled around the operator's hand and impede the procedure Such a snare is shown in U.S. Patent No. 3,828,790.
This drawback can be obviated by providing a snare which is rotatable while the handle is held stationary in the operator's hand. A surgical snare having an operating cable rotatable in a sheath by means of a rotating assembly mounted above a snare handle is shown in U.S. Patent No. 3,955,578. While the handle-mounted rotating assembly overcomes a problem of the need to manipulate the entire instrument in order to position the snare, its location away from the main axis of the handle makes it difficult to hold the handle stationary ''~
.
-- ~290~16 while rotation is effected. The problem associated with a rotating assembly mounted away from the longitudinal axis of the handle are increased for operators with small hands.
S In both U.S. Patent No. 3,838,790 and 3,995,578 the operating cable is attached to the handle by external clamping means, such as a clamping knob threaded onto the handle or a set screw threaded into the handle.
Knobs and set screws not convenient, are sometimes difficult to use or loosen in use, and are easily lost during the assembly and disassembly of the instrument necessary for cleaning or to replace damaged or bent snares.
Disclosure of the Invention .
The invention provides an improved surgical snare having an operating cable freely rotatable while the handle is maintained steady, having a rotating assembly mounted in the handle so.that the axis of rotation of the assembly is essentially coaxial with the longitudinal axis of the handle and having a quick disconnect-connect means for attaching the operating cable to the rotating assembly without external clamping means.
More particularly, the invention provides, in an endoscopic snare having a sheath, an electrically conducting cable with a snare at a distal end movable into and out of the sheath, and a manual operating assembly attached to the sheath and to a proximal end of the cable, the improvement in the manual operating assembly of an elongated holder having a body portion and a cable actuator wherein the body portion has a central longitudinal recess that opens through two opposite sides to define a pair of parallel guides upon which the actuator is mounted; the actuator has an electrically conducting, snare-rotating member that is slidable between the parallel guides; the snare-rotating member and the proximal end of the cable each have means cooperating to form a quick ~.2~90X16 disconnect connection; and the holder, the snare-rotating shaft and the cable are constructed and arranged to have a common longitudinal axis.
The body portion is rectangular is cross-section and the central longitudinal recess opens through the two wider sides of the rectangle. The cable actuator has a transverse rectangular recess for slidably receiving the rectangular body.
The electrically conducting, snare-rotating member comprises a block with a bore. The block is located within the recess of the actuator and retained against rotation by the transverse shape of the recess in the actuator. A finger operable rotary member is journaled in the bore. An enlarged cylindrical portion with a plastic sleeve extends from the block and beyond the distal face of the actuator. It fits within the parallel guides and protrudes from opposite sides of the central longitudinal recess of the body so that it is easily gripped and turned with the operator's fingers.
Means are provided communicating through the actuator and the block to connect the block to the actuator and to make sliding electrical contact with the rotatably held shaft. This means preferably comprises a contact post passing through an aperture in the actuator and threadedly received in a corresponding aperture in the block. The aperture in the block intersects the central bore of the block so that a spring retained within the contact post makes sliding contact with the rotatably held cylindrical shaft.
Means are provided on both the proximal end of the cable and in the extending portion of the snare-rotating member that cooperate to form a quick-disconnect connection.
The proximal end of the cable has a small transverse rod at the end of the cable and the snare-rotating member has an elongated aperture in its distal face that forms lZ90~16 a passage into a central recess that has a transverse stop and a spring biased detent, all of which allow the proximal end of the cable to be inserted and releasably engaged in the snare-rotating member.
The proximal end of the body has a thumb ring and each one of the lateral sides of the actuator has a finger ring. The thumb and finger rings are coplanar with each other, with the holder, and with the electrically conducting, snare-rotating member.
The improved rotatable snare provides the advantage of a compact, easily handled instrument. The location of the snare turning knob within the parallel guides upon which the cable actuator slides back and forth to protract and retract the cable ensures facile manipulability lS by all operators regardless of hand size. Also, the construction of the snare-rotating member, while compact, provides an effective mèchanical and electrical inter-connection with the snare that avoids the need for tools or screws in connecting or disconnecting the snare and facilitates easy removal of the rotating member from the actuator.
Other advantages and a more complete understanding of the invention will be had from the following detailed description when taken in conjunction with the accompanying drawin9s.
Brief Description of Drawings Figure 1 is a top plan view of the rotatable surgical snare of the present invention;
Figure 2 is a longitudinal sectioned view of the surgical snare of Figure 1 taken along the line 2-2;
Figure 3 is a side elevational view of the quick disconnect-connect mechanism in the proximal end of the cable;
Figures 4a and 4b are side elevational views of the snare-rotating member;
1290;~6 Flgure 4c i~ an end el~vat~onal view taken ~rom the left en~ o2 Figure 4a:
Figure6 Sa and 5b are pre-shaped section~ of one longi~udlnal half o~ the snare-rotating member taken S along the lines 5a-5a and 5b-5b, respectively, o~
Figure 4c; and Figure 6 is a partial longltudinal 6ectlonal view of the snare-rotatlng member taken along the line 5a-5b of Flgure 4a.
B~t Mode ~or Carrvins Out the Inven~lon Re~Qrrlng to Figure l, the i~provQd rotatable ~nare instrument o~ th~ present invention i- designat~d gen~rally as 10 and comprises a surglcal snare 20, a flexibl-portion 40 an~ a manual operatlng as3embly ~0.
As ~hown in Figure l, the ~nar~ 20 ~ J in its pro-tr~cted position and i~ connected to thQ diotal end of an electrlcally conductl~e ~l~xiblQ operAtlng cable 22 by means or a crlmped-on collar 24. The conductlve flexlbl- operating cable 22 has a proximal sti~fenQd rod-lik- portion 26 to ~acll~tat- connection to thQ
manual op~rating assembly 60. ThQ rod-llxQ port~on 26 18 covered with a non-conduatlve m~tQrial ~acket 28.
~h~ opQrating cable 22 1~ contained within a non-conduc-tivo ~l~xible ~heath 42 open at the di~tal ~nd to allow retraction and protractlon o~ th- snare 20. $h~ heat~ 42 has a thr~aded coupler 44 at the proxlmal end for attachm~nt to a ~econd coupler 46 for mounting the ~lexible portion 40 to the ~anual operating a~embly 60.
Tho ~econd ¢oupler 46 ha~ a threaded portion 48 ~or attachment to the coupler 44 and a luer-lock llkQ
portlon 50 ~or ~ttachment to a corr~-ponding lu-r-loak like portion 52, on the operating a~embIy 60. A~ bQst ~-en in Figure 2, th- luer-lo¢k liXe portion 52 derine~
a pa~sag~ 56 ror receivlng the ~tlrr~ned rod-li~e 3~ portion 26 Or the cabl~ 22. Alternati~Qly, the conn-ction iE~
.'r . '~
`-- 1290~16 ~
between the sheath 42 and the manual operating assembly 60 may be one-piece, but assembly and disassembly of the instrument--which can be l.Sm long--is facilitated by the coupler arrangement as shown in Figure 1.
The manual operating assembly 60 has an elongated generally rectangular body 64 with a thumb ring 66 at the proximal end. The body 64 has a central longitudinal recess 70 that opens through the two wider sides of the rectangle, resulting in a pair of elongated guide bars 72, 74. The inwardly facing surfaces 73, 75 are cylindrically curved. A cable actuator 80, having a generally rectangular transverse through-passage 82 for receiving the elongated body 64, is slidable on the guide bars 72, 74, by means of a pair of finger rings 84, 86 located on opposite lS lateral sides of the actuator and in the same plane as the thumb ring 66. The through-passage 82 of the actuator 80 engages an electrical-torque transmitting member 90 that is located between the interior surfaces 73, 75 of the guide bars 72, 74.
The electrical-torque transmitting member 90 has an electrically conductive block 100 secured to the actuator and in which a first reduced diameter portion 108 of a cylindrical snare-rotating shaft 110 is journaled.
As best seen in Figure 2, the cylindri,cal snare-rotating shaft 110 is retained in the electrically conducting block 100 for relative rotation by means of a resilient retaining ring 112 received in a channel 114 in a second reduced diameter portion 116 of the cylindrical snare-rotating shaft 110. The block 100 is constructed to fit within the actuator 80 without protruding beyond it into the recess 70. The block 100 is retained against rotation within the actuator 80 by the transverse shape of the through passage 82 and retained within the actuator 80 by means of a contact post 120 that passes t,hrough a first aperture 122 in the actuator 80 and `~ ~290X~6 ~
that is threadedly received in a second corresponding aperture 126 in the block 100. Electrical contact between the contact post 120 and the snare-rotating shaft 110 is established by means of a spring 128 contained within a recess 130 at one end of the contact post 120. The spring 128 is in sliding contact with the reduced diameter portion 108 of the snare-rotating shaft 110 received within the block 100.
As seen in Figure 2, the cylindrical snare-rotating shaft 110 has a distally facing expanded diameter knob portion 132 extending beyond the distal face of the actuator 80. The knob 132 has a diameter larger than the width of the narrow sides of the rectangular body 64 of the manual operating assembly 60 and is constructed so as to nest within the cylindrical interior surfaces 73, 75 of the guide bars 72, 74. The knob 132 protrudes from the central longitudinal recess 70 of the rectangular body 74, so that it is easily gripped by the operator's fingers for manual rotation. The knob I32 is covered with a non-conducting material 134 and may be knurled to facilitate gripping and rotation.
The distal end of the operating cable 22 and the snare-rotating shaft 110 each have means cooperating to form a ~uick-disconnect connection that locates the axis of rotation of the cable 22, the shaft 110, and the manual operating assembly 60 along a common line.
As shown in Figure 3, the distal end of the rod-like portion 26 of the cable 22 has a generally cylindrical push portion 140 and a generally cylindrical locking portion 142 normal to and interposed between the push portion 140 and the rod-like portion 26 of the cable 22.
As best seen in Figures 4a, 4b, 4c, 5a, 5b, and 6 the snare-rotating shaft 110 is constructed so that a member 149 in the interior of the shaft 110 acts as a spring biased detent to hold the locking portion 142 of 1290216 ~
the cable 22. The shaft 110 has a centrally located circular longitudinal recess 150 passing through the first and second reduced diameter portions 108, 116 and into the knob portion 132 where it terminates at the distally facing end 138 of the knob portion 132 in a elliptically shaped, centrally located recess 152. The elliptical recess 152 is dimensioned to receive the generally cylindrical locking portion 142 of the rod-like portion 26 of the cable 22.
Two slots 160, 170 transverse to the elliptical recess 152 and 180 apart-are located in the knob 132.
The slots 160, 170 extend from the exterior of the knob 132 to intersect the elliptical recess 152. As shown in Figures 5a and 5b, the slots 160, 170 communicate with the elliptical recess 152 and, in the orientation shown in Figures 5a and 5b, have a low ceiling pDrtion 162, 172 near the long axis of the cylindrical recess 152 and a high ceiling portion 164, 174 near the short axis of the cylindrical recess. The intersection of the circular recess 150, the elliptical recess 152 and the low ceiling portions 162, 172 of the slots 160, 170 define two locking-portion sliding-surfaces 166, 176.
The radial sides of the high ceiling portions 164, 174 define locking-portion stop-surfaces 168, 178.
A spring biased circular elongated plunger 180 is located within the circular recess 150. The plunger 180 has an enlarged head 182 to retain a spring 184 within the circular recess 150 proximally of the head 182.
The plunger 180 and spring 184 are retained within the circular recess 150 by means of a threaded fastener screwed into a threaded proximally facing portion 154 in the circular recess 150. The head 182 has a centrally located distally facing dimple 186 dimensioned so as to receive the push portion 140 of the cable 22.
129()~16 To assemble the instrument, the transverse rod on the end of the cable is inserted into the elliptical opening in the knob and rotated 90. A spring-biased detent retains the rod in the internal grooves of the knobs. More particularly, the distal end of the cable 22 is passed through the passage 56 in the luer-like portion 52 of the manual operating assembly 60. The cylindrical locking portion 142 of the cable 22 is inserted through the elliptical recess 152 in the knob 132.
Pressure is applied during insertion so that the cylindrical locking portion 142 contacts the locking portion sliding surfaces 166, 170 and the push portion 142 engages the dimple 186 to depress the plunger 180. Reorientation through rotation by'about 90 of the cylindrical locking portion 142 along the sliding surfaces 166, 176 causes the locking portion 142 to slide from the low ceiling portions 162, 172 to the.high ceiling portions 164, 174 until reorientation is completed by the locking portion 142 encountering stopping surfaces 168, 178. Releasing the pressure on the cable allows thé plunger 180 to hold the locking portion 142 securely in the high ceiling portions 164, 174. Removal of the cable 22 from the snare-rotating shaft 110 is effected by applying pressure to the cable 22 to depress the plunger 180, rotating the locking portion 142 out of the high and low ceiling portions 164, 174, 162, 172 and withdrawing it from the elliptical recess 152.
Variations and modifications of the invention will be apparent to those skilled in the art from the above detailed description. Therefore, it is to be understood that, within the scope of the appended claims, the inven-tion can be practiced otherwise than as specifically shown and described.
Background Art Polypectomes for surgically removing colonic polyps usually comprise an electrocautery snare retractable into a long flexible sheath by means of an electrically conducting cable and a handle connected to the sheath and operating cable for retracting and protracting the snare and for connection to a source of electric power.
In use, the polypectome with the snare retracted is positioned near a polyp with the aid of an endoscope.
Once the polyp is locatèd, the operator employes the handle to protract the snare to its open position. The snare, however, rarely protracts from the sheath ideally positioned to engage the polyp; the operator must manipulate the entire handle in order to rotate the snare. Since the handle has an electrical connection, it is not uncommon for the connection to become entangled around the operator's hand and impede the procedure Such a snare is shown in U.S. Patent No. 3,828,790.
This drawback can be obviated by providing a snare which is rotatable while the handle is held stationary in the operator's hand. A surgical snare having an operating cable rotatable in a sheath by means of a rotating assembly mounted above a snare handle is shown in U.S. Patent No. 3,955,578. While the handle-mounted rotating assembly overcomes a problem of the need to manipulate the entire instrument in order to position the snare, its location away from the main axis of the handle makes it difficult to hold the handle stationary ''~
.
-- ~290~16 while rotation is effected. The problem associated with a rotating assembly mounted away from the longitudinal axis of the handle are increased for operators with small hands.
S In both U.S. Patent No. 3,838,790 and 3,995,578 the operating cable is attached to the handle by external clamping means, such as a clamping knob threaded onto the handle or a set screw threaded into the handle.
Knobs and set screws not convenient, are sometimes difficult to use or loosen in use, and are easily lost during the assembly and disassembly of the instrument necessary for cleaning or to replace damaged or bent snares.
Disclosure of the Invention .
The invention provides an improved surgical snare having an operating cable freely rotatable while the handle is maintained steady, having a rotating assembly mounted in the handle so.that the axis of rotation of the assembly is essentially coaxial with the longitudinal axis of the handle and having a quick disconnect-connect means for attaching the operating cable to the rotating assembly without external clamping means.
More particularly, the invention provides, in an endoscopic snare having a sheath, an electrically conducting cable with a snare at a distal end movable into and out of the sheath, and a manual operating assembly attached to the sheath and to a proximal end of the cable, the improvement in the manual operating assembly of an elongated holder having a body portion and a cable actuator wherein the body portion has a central longitudinal recess that opens through two opposite sides to define a pair of parallel guides upon which the actuator is mounted; the actuator has an electrically conducting, snare-rotating member that is slidable between the parallel guides; the snare-rotating member and the proximal end of the cable each have means cooperating to form a quick ~.2~90X16 disconnect connection; and the holder, the snare-rotating shaft and the cable are constructed and arranged to have a common longitudinal axis.
The body portion is rectangular is cross-section and the central longitudinal recess opens through the two wider sides of the rectangle. The cable actuator has a transverse rectangular recess for slidably receiving the rectangular body.
The electrically conducting, snare-rotating member comprises a block with a bore. The block is located within the recess of the actuator and retained against rotation by the transverse shape of the recess in the actuator. A finger operable rotary member is journaled in the bore. An enlarged cylindrical portion with a plastic sleeve extends from the block and beyond the distal face of the actuator. It fits within the parallel guides and protrudes from opposite sides of the central longitudinal recess of the body so that it is easily gripped and turned with the operator's fingers.
Means are provided communicating through the actuator and the block to connect the block to the actuator and to make sliding electrical contact with the rotatably held shaft. This means preferably comprises a contact post passing through an aperture in the actuator and threadedly received in a corresponding aperture in the block. The aperture in the block intersects the central bore of the block so that a spring retained within the contact post makes sliding contact with the rotatably held cylindrical shaft.
Means are provided on both the proximal end of the cable and in the extending portion of the snare-rotating member that cooperate to form a quick-disconnect connection.
The proximal end of the cable has a small transverse rod at the end of the cable and the snare-rotating member has an elongated aperture in its distal face that forms lZ90~16 a passage into a central recess that has a transverse stop and a spring biased detent, all of which allow the proximal end of the cable to be inserted and releasably engaged in the snare-rotating member.
The proximal end of the body has a thumb ring and each one of the lateral sides of the actuator has a finger ring. The thumb and finger rings are coplanar with each other, with the holder, and with the electrically conducting, snare-rotating member.
The improved rotatable snare provides the advantage of a compact, easily handled instrument. The location of the snare turning knob within the parallel guides upon which the cable actuator slides back and forth to protract and retract the cable ensures facile manipulability lS by all operators regardless of hand size. Also, the construction of the snare-rotating member, while compact, provides an effective mèchanical and electrical inter-connection with the snare that avoids the need for tools or screws in connecting or disconnecting the snare and facilitates easy removal of the rotating member from the actuator.
Other advantages and a more complete understanding of the invention will be had from the following detailed description when taken in conjunction with the accompanying drawin9s.
Brief Description of Drawings Figure 1 is a top plan view of the rotatable surgical snare of the present invention;
Figure 2 is a longitudinal sectioned view of the surgical snare of Figure 1 taken along the line 2-2;
Figure 3 is a side elevational view of the quick disconnect-connect mechanism in the proximal end of the cable;
Figures 4a and 4b are side elevational views of the snare-rotating member;
1290;~6 Flgure 4c i~ an end el~vat~onal view taken ~rom the left en~ o2 Figure 4a:
Figure6 Sa and 5b are pre-shaped section~ of one longi~udlnal half o~ the snare-rotating member taken S along the lines 5a-5a and 5b-5b, respectively, o~
Figure 4c; and Figure 6 is a partial longltudinal 6ectlonal view of the snare-rotatlng member taken along the line 5a-5b of Flgure 4a.
B~t Mode ~or Carrvins Out the Inven~lon Re~Qrrlng to Figure l, the i~provQd rotatable ~nare instrument o~ th~ present invention i- designat~d gen~rally as 10 and comprises a surglcal snare 20, a flexibl-portion 40 an~ a manual operatlng as3embly ~0.
As ~hown in Figure l, the ~nar~ 20 ~ J in its pro-tr~cted position and i~ connected to thQ diotal end of an electrlcally conductl~e ~l~xiblQ operAtlng cable 22 by means or a crlmped-on collar 24. The conductlve flexlbl- operating cable 22 has a proximal sti~fenQd rod-lik- portion 26 to ~acll~tat- connection to thQ
manual op~rating assembly 60. ThQ rod-llxQ port~on 26 18 covered with a non-conduatlve m~tQrial ~acket 28.
~h~ opQrating cable 22 1~ contained within a non-conduc-tivo ~l~xible ~heath 42 open at the di~tal ~nd to allow retraction and protractlon o~ th- snare 20. $h~ heat~ 42 has a thr~aded coupler 44 at the proxlmal end for attachm~nt to a ~econd coupler 46 for mounting the ~lexible portion 40 to the ~anual operating a~embly 60.
Tho ~econd ¢oupler 46 ha~ a threaded portion 48 ~or attachment to the coupler 44 and a luer-lock llkQ
portlon 50 ~or ~ttachment to a corr~-ponding lu-r-loak like portion 52, on the operating a~embIy 60. A~ bQst ~-en in Figure 2, th- luer-lo¢k liXe portion 52 derine~
a pa~sag~ 56 ror receivlng the ~tlrr~ned rod-li~e 3~ portion 26 Or the cabl~ 22. Alternati~Qly, the conn-ction iE~
.'r . '~
`-- 1290~16 ~
between the sheath 42 and the manual operating assembly 60 may be one-piece, but assembly and disassembly of the instrument--which can be l.Sm long--is facilitated by the coupler arrangement as shown in Figure 1.
The manual operating assembly 60 has an elongated generally rectangular body 64 with a thumb ring 66 at the proximal end. The body 64 has a central longitudinal recess 70 that opens through the two wider sides of the rectangle, resulting in a pair of elongated guide bars 72, 74. The inwardly facing surfaces 73, 75 are cylindrically curved. A cable actuator 80, having a generally rectangular transverse through-passage 82 for receiving the elongated body 64, is slidable on the guide bars 72, 74, by means of a pair of finger rings 84, 86 located on opposite lS lateral sides of the actuator and in the same plane as the thumb ring 66. The through-passage 82 of the actuator 80 engages an electrical-torque transmitting member 90 that is located between the interior surfaces 73, 75 of the guide bars 72, 74.
The electrical-torque transmitting member 90 has an electrically conductive block 100 secured to the actuator and in which a first reduced diameter portion 108 of a cylindrical snare-rotating shaft 110 is journaled.
As best seen in Figure 2, the cylindri,cal snare-rotating shaft 110 is retained in the electrically conducting block 100 for relative rotation by means of a resilient retaining ring 112 received in a channel 114 in a second reduced diameter portion 116 of the cylindrical snare-rotating shaft 110. The block 100 is constructed to fit within the actuator 80 without protruding beyond it into the recess 70. The block 100 is retained against rotation within the actuator 80 by the transverse shape of the through passage 82 and retained within the actuator 80 by means of a contact post 120 that passes t,hrough a first aperture 122 in the actuator 80 and `~ ~290X~6 ~
that is threadedly received in a second corresponding aperture 126 in the block 100. Electrical contact between the contact post 120 and the snare-rotating shaft 110 is established by means of a spring 128 contained within a recess 130 at one end of the contact post 120. The spring 128 is in sliding contact with the reduced diameter portion 108 of the snare-rotating shaft 110 received within the block 100.
As seen in Figure 2, the cylindrical snare-rotating shaft 110 has a distally facing expanded diameter knob portion 132 extending beyond the distal face of the actuator 80. The knob 132 has a diameter larger than the width of the narrow sides of the rectangular body 64 of the manual operating assembly 60 and is constructed so as to nest within the cylindrical interior surfaces 73, 75 of the guide bars 72, 74. The knob 132 protrudes from the central longitudinal recess 70 of the rectangular body 74, so that it is easily gripped by the operator's fingers for manual rotation. The knob I32 is covered with a non-conducting material 134 and may be knurled to facilitate gripping and rotation.
The distal end of the operating cable 22 and the snare-rotating shaft 110 each have means cooperating to form a ~uick-disconnect connection that locates the axis of rotation of the cable 22, the shaft 110, and the manual operating assembly 60 along a common line.
As shown in Figure 3, the distal end of the rod-like portion 26 of the cable 22 has a generally cylindrical push portion 140 and a generally cylindrical locking portion 142 normal to and interposed between the push portion 140 and the rod-like portion 26 of the cable 22.
As best seen in Figures 4a, 4b, 4c, 5a, 5b, and 6 the snare-rotating shaft 110 is constructed so that a member 149 in the interior of the shaft 110 acts as a spring biased detent to hold the locking portion 142 of 1290216 ~
the cable 22. The shaft 110 has a centrally located circular longitudinal recess 150 passing through the first and second reduced diameter portions 108, 116 and into the knob portion 132 where it terminates at the distally facing end 138 of the knob portion 132 in a elliptically shaped, centrally located recess 152. The elliptical recess 152 is dimensioned to receive the generally cylindrical locking portion 142 of the rod-like portion 26 of the cable 22.
Two slots 160, 170 transverse to the elliptical recess 152 and 180 apart-are located in the knob 132.
The slots 160, 170 extend from the exterior of the knob 132 to intersect the elliptical recess 152. As shown in Figures 5a and 5b, the slots 160, 170 communicate with the elliptical recess 152 and, in the orientation shown in Figures 5a and 5b, have a low ceiling pDrtion 162, 172 near the long axis of the cylindrical recess 152 and a high ceiling portion 164, 174 near the short axis of the cylindrical recess. The intersection of the circular recess 150, the elliptical recess 152 and the low ceiling portions 162, 172 of the slots 160, 170 define two locking-portion sliding-surfaces 166, 176.
The radial sides of the high ceiling portions 164, 174 define locking-portion stop-surfaces 168, 178.
A spring biased circular elongated plunger 180 is located within the circular recess 150. The plunger 180 has an enlarged head 182 to retain a spring 184 within the circular recess 150 proximally of the head 182.
The plunger 180 and spring 184 are retained within the circular recess 150 by means of a threaded fastener screwed into a threaded proximally facing portion 154 in the circular recess 150. The head 182 has a centrally located distally facing dimple 186 dimensioned so as to receive the push portion 140 of the cable 22.
129()~16 To assemble the instrument, the transverse rod on the end of the cable is inserted into the elliptical opening in the knob and rotated 90. A spring-biased detent retains the rod in the internal grooves of the knobs. More particularly, the distal end of the cable 22 is passed through the passage 56 in the luer-like portion 52 of the manual operating assembly 60. The cylindrical locking portion 142 of the cable 22 is inserted through the elliptical recess 152 in the knob 132.
Pressure is applied during insertion so that the cylindrical locking portion 142 contacts the locking portion sliding surfaces 166, 170 and the push portion 142 engages the dimple 186 to depress the plunger 180. Reorientation through rotation by'about 90 of the cylindrical locking portion 142 along the sliding surfaces 166, 176 causes the locking portion 142 to slide from the low ceiling portions 162, 172 to the.high ceiling portions 164, 174 until reorientation is completed by the locking portion 142 encountering stopping surfaces 168, 178. Releasing the pressure on the cable allows thé plunger 180 to hold the locking portion 142 securely in the high ceiling portions 164, 174. Removal of the cable 22 from the snare-rotating shaft 110 is effected by applying pressure to the cable 22 to depress the plunger 180, rotating the locking portion 142 out of the high and low ceiling portions 164, 174, 162, 172 and withdrawing it from the elliptical recess 152.
Variations and modifications of the invention will be apparent to those skilled in the art from the above detailed description. Therefore, it is to be understood that, within the scope of the appended claims, the inven-tion can be practiced otherwise than as specifically shown and described.
Claims (14)
1. In an endoscopic snare having a sheath, an electrically conducting cable with a snare at a distal end movable into and out of the sheath and a manual operating assembly attached to the sheath and to a proximal end of the cable, the improvement wherein the manual operating assembly comprises an elongated holder having a body portion, and a cable actuator, said body portion having a central longitudinal recess open through two opposite sides to define a pair of parallel guides upon which the actuator is slidably mounted, said actuator having an electrically conducting snare-rotating member between said parallel guides, said snare-rotating member and the proximal end of the cable each having means cooperating to form a quick disconnect connection, and said elongated holder, snare-rotating member and cable being constructed and arranged to have a common longitudinal axis.
2. The endoscopic snare as claimed in Claim 1 wherein the body portion is rectangular in cross-section and wherein the central longitudinal recess opens through the two wider opposite sides of the rectangular body.
3. The endoscopic snare as claimed in Claim 2 wherein the cable actuator has a transverse rectangular recess for slidably receiving the body portion of the manual operating assembly.
4. The endoscopic snare as claimed in Claim 3 wherein the electrically conducting snare-rotating member comprises a block having a bore located within and retained against rotation by the rectangular recess of the cable actuator, and a cylindrical shaft rotatably held within the bore of the block.
5. The endoscopic snare as claimed in Claim 4 wherein the cylindrical shaft has a cylindrical knob extending beyond a distal face of the actuator and having a diameter so as to protrude from opposite sides of the central longitudinal recess in the two wider opposite sides of the rectangular body.
6. The endoscopic snare as claimed in Claim 4 wherein the actuator and the block have means communi-cating there through to connect the block to the actuator and to make sliding electric contact with the rotably held cylindrical shaft.
7. The endoscopic snare as claimed in Claim 6 wherein the means connecting the block to the actuator and making contact with the shaft comprises a contact post received through a first recess in the actuator and threadly received in a second recess in the block, and a spring retained within the contact post extending out of the post and in sliding contact with the shaft.
8. The endoscopic snare as claimed in Claim 1 wherein the means cooperating to form the quick-disconnect connection comprises a cylindrical transverse rod located near the proximal end of the cable and further comprises an elliptical recess transversely centrally located in a distal face of the snare-rotating member, said recess communicating with at least one locking groove, and a spring biased member retained in the shaft of the snare-rotating member and located to releasably engage the rod in the groove.
9. The endoscopic snare as claimed in Claim 1 wherein the proximal end of the body has a thumb ring and each one of the lateral sides of the actuator has a finger ring, said thumb ring and finger rings being coplanar with each other, with the elongated holder, and with the electrically conducting snare-rotating member.
10. In a endoscopic snare having a sheath, an electrically conducting cable with a snare at a distal end movable into and out of the sheath and a manual operating assembly attached to the sheath and to a proximal end of the cable, the improvement wherein the manual operating assembly comprises an elongated holder having a rectangular body portion, a thumb ring, and a cable actuator, said body portion having a central longitudinal recess open through the two wider opposite sides of the rectangular body to define a pair of parallel guides upon which the actuator is slidably mounted, said parallel guides having cylindrically curved interior surfaces, said actuator having a finger ring on each one of two lateral sides and a transverse rectangular recess, an electrically conducting snare-rotating member located with said actuator, said snare-rotating member comprising a block journaled to receive a snare rotating shaft attached for relative rotation, said block and shaft slidable between said curved interior surfaces by means of said actuator, said block retained against rotation within the recess in said actuator, said snare-rotating shaft having a distally facing manual rotating knob extending beyond the distal face of the actuator and out of the opposite sides of the recess, said rotating knob and the proximal end of the cable each having means cooperating to form a spring biased detent-like connection, said elongated holder, electrically conducting, snare-rotating member and cable defining a common longitudinal axis, and said thumb and finger rings being coplanar with each other and with the holder.
11. In an endoscopic snare having a sheath, a cable with a snare at a distal end movable into and out of the sheath and a manual operating assembly attached to the sheath and to the proximal end of the cable, the improvement wherein the manual operating assembly comprising a cable actuator having a snare-rotating member, the proximal end of the cable and said snare-rotating member each have means cooperating to form a quick disconnect connection wholly within said snare-rotating member and disconnectable by longitudinal and rotational movement of the cable relative to the snare-rotating member, said actuator, snare-rotating member, and cable having a common longitudinal axis.
12. The endoscopic snare as claimed in claim 11 wherein the means cooperating to form the quick disconnect connection comprises a transverse rod located near the proximal end of the cable and further comprises an elliptical recess transversely centrally located in a distal face of the snare-rotating member, said recess communicating with at least one locking groove, and a spring biased member retained in the shaft of the snare-rotating member located to releasably engage the rod in the groove.
13. The endoscopic snare as claimed in claim 12 wherein said recess communicates with a pair of locking grooves located normal to the elliptical recess, and 180° apart from one another.
14. The endoscopic snare as claimed in Claim 11 wherein the cooperating means is constructed to disconnect in response to an amount of notational movement of approximately 90°.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US862,683 | 1986-05-13 | ||
| US06/862,683 US5066295A (en) | 1986-05-13 | 1986-05-13 | Rotatable surgical snare |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1290216C true CA1290216C (en) | 1991-10-08 |
Family
ID=25339049
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000536761A Expired - Fee Related CA1290216C (en) | 1986-05-13 | 1987-05-11 | Rotatable surgical snare |
Country Status (2)
| Country | Link |
|---|---|
| US (1) | US5066295A (en) |
| CA (1) | CA1290216C (en) |
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Also Published As
| Publication number | Publication date |
|---|---|
| US5066295A (en) | 1991-11-19 |
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