WO2014049543A2

WO2014049543A2 - Multifunctional surgical device

Info

Publication number: WO2014049543A2
Application number: PCT/IB2013/058872
Authority: WO
Inventors: Swati SARNAIK
Original assignee: Sarnaik Swati
Priority date: 2012-09-29
Filing date: 2013-09-26
Publication date: 2014-04-03
Also published as: WO2014049543A3

Abstract

A surgical tool for use in minimally invasive surgical procedures is disclosed characterized in achievement of among a plurality of user- selectable surgical functionalities via operably-linked multifaceted and opposing jaw members. Also disclosed are manner of deployment and operation of said surgical tool.0 2.

Description

Title of the invention:

MULTIFUNCTIONAL SURGICAL DEVICE

[000] FIELD OF THE INVENTION

[001 ] The present invention relates generally to field of surgical devices and more particularly to the construction and operation of an indexable multifunctional tool for use in minimally invasive surgery.

[002] REFERENCES TO PRECEDING APPLICATIONS

[003] This application derives benefit of provisional application No.

2515/MUM/2012 filed on 29 August 2012 the contents of which are incorporated in entirety herein by reference.

[004] BACKGROUND OF THE INVENTION

[005] A variety of devices are known in the art to aid in performing surgical procedures such as cutting, grasping, cauterization and the like. Specialized among these devices are minimally invasive surgery (MIS) instruments which comprise distal effectors connected via an intermediate shaft to proximal actuators. In standard minimally invasive surgeries, a patient's abdomen is insufflated with gas, and cannula sleeves are passed through small incisions to provide entry ports for these specialized surgical instruments.

[006] Effectors of MIS instruments are typically individualistic to surgical function intended and thus, demand frequent interchange according to sequence of functionalities required. This is highly deleterious to health of the patient and unnecessarily increases complexity of the surgery. Figuratively, there are several problems associated with exchanging MIS instruments during a surgical procedure. First, such changes are time-consuming and lengthen operating time, which, in turn, increases costs and the time a patient is anesthetized. Second, it may disrupt flow of a surgical procedure and breach the surgeon's concentration. Avoidance of these situations via adoption of a tool that can provide multiple functions and thereby reduce the number of instrument exchanges required is a pressing need of the art.

[007] Attempts to resolve said needs find mention in the art .

US5893875 discloses a surgical instrument with replaceable end effector assemblies. A surgeon can switch between grasping and cutting with the same tool. The main drawback is that the surgeon must withdraw the instrument from the patient to replace end effectors. WO 201 1/161626 A2 discloses a four jawed combined scissor-grasper surgical tool for use in laparoscopy. Cutting and grasping functionalities are respectively enabled via movement of a pair of such specially contoured jaw members sliding against of splaying apart from the other pair. Also discloses means for achieving selectable interlocking of the jaw members and mechanical linkage for their actuation by human user. This tool has ability to perform only two functions without retracting from surgical port which limits the applicability of this device.

[008] US patent US6024744 comprises a combined bipolar electrosurgical cutting and grasping instrument where the grasping surfaces are contained within the shape of a standard surgical scissor. However, being contained within same arm, the cutting and grasping portions are in same angle of motion, which presents a risk of accidental cuts or clamps. Moreover this tool can perform only two functions without retracting from surgical port while the instrument.

[009] US5509923 discloses a device for dissecting, grasping and/or cutting an object has at least two elongate elements at least a portion of at least one of the elements is formed from a pseudo- elastic material, preferably pseudo-elastic shape memory alloy. End portions of the elements can be moved away from one another and then towards one another to dissect, grasp and /or cut with the elements. However the use of pseudo-elastic material allows limited choices on the angle of cut and exact portion of the tissue being grasped.

[010] US6358268 discloses a surgical instrument with a fixed member including a fixed scissor and a fixed jaw and a pivotable member including pivot able scissors and pivot able jaw. Although the cutting and grasping actions may happen without retracting the tool from the surgical port, the moving blade occupies additional space while gasping and similarly the grasper occupies additional space while cutting. This not only makes difficult for the surgeon to use any of these functions but also partially obstructs the view of intended area.

[01 1 ] US5397325 discloses a suturing device which has a tubular elongated shaft terminating into a jaw assembly at the distal end and a handle assembly at the proximal end thereof. The jaw assembly includes a first jaw member pivotally connected to a second jaw member, an actuator rod extending longitudinally within the length of said shaft is connected at its proximal end to handle assembly and is pivotally connected at its distal end to said jaw assembly. The first jaw member has cupped recess with a wheel assembly that includes needle mount. Needle lies within the recess and can be protracted in open position. This invention provides suturing functions with adequate needle control however does not offer means to grasp of hold tissue and hence the slippery tissue must be grasped by a second instrument. This can become difficult for the surgeon and potentially have complications for the patient. This adds surgery duration and trauma to the patient.

[012] From the study currently undertaken the existing devices and instruments are generally limited to two or three maximum functionalities and therefore, scope for further research and development is preserved. It would be desirable to keep the overall design of the MIS tool as simple as possible by assembling the system with fewer parts and/or less complicated assembly and yet be able to achieve plurality of functionalities with high degree of precision and accuracy as possible. Therefore, though plural functionality is desired, any surgical tool / device providing the same must necessarily be qualified by safe, fault-free and wide field of operation.

[013] The present inventor, in cognizance of aforesaid needs and technical problems, has undertaken focused research and come up with novel solution to effectively address the same. The following detailed description presents one way of performing the present invention.

[014] OBJECTS OF THE PRESENT INVENTION

[015] The principle object of the present invention is to provide a multifunctional surgical instrument with suitable construction and operation that provides accurate performance among multiple surgical functions in any sequence.

[016] Yet another object of the present invention is to provide multifunctionality to a MIS instrument whereby the effector can be indexed and mechanically interlocked so as to retain the intended position for error-free performance of particular surgical function.

[017] Yet another object of the present invention is to provide a multifunctional surgical instrument wherein the effector is equipped with facets corresponding to different topologies for interchangeably performing different surgical functions without retraction of the instrument from surgery port.

[018] Yet another object of the present invention is to provide a multifunctional surgical instrument which reduces the quantity of instrumentation necessary for surgical procedures in which scissors, graspers, dissectors, needle driver, forceps and like and/or change of end effectors otherwise required.

[019] Yet another object of the present invention is to provide a multifunctional surgical instrument wherein the effector has built in safety mechanism to allow the tool to migrate between different surgical configurations only when the jaw is in open position.

[020] Yet another object of the present invention is to provide a multifunctional surgical instrument with only two jaws to avoid obstruction of function and view during multifunctional surgical procedures.

[021 ] Yet another object of the present invention is to provide a multifunctional surgical instrument where in cutting functionality is enabled via shear forces achieved at the edges of jaws by their relative motion thus avoiding open blade configuration. [022] Yet another object of the present invention is to provide a quad- functional surgical instrument which reduces the amount of dexterity needed by a surgeon performing surgical procedures in which scissors, graspers, dissectors, needle driver, forceps and like end effectors are required.

[023] Yet another object of the present invention is to provide a quad- functional surgical instrument which is amenable to common art pre-surgical sterilization techniques.

[024] Yet another object of the present invention is to provide a quad- functional surgical instrument which is capable of repeated use decreasing the amount of medical waste generated.

[025] It would be convenient hereinafter to describe the present invention in greater detail by reference to the accompanying drawings which illustrate preferred embodiments of the invention. The particularity of the drawings and the related description is not to be understood as superseding the generality of the broad identification of the invention as defined by the appended claims.

[026] BRIEF DESCRIPTION OF THE DRAWINGS

[027] Fig 1 (a to e) illustrates constructional features of the proposed surgical tool made in accordance with principles of the present invention.

[028] Fig 2 (a to d) illustrates various functional configurations that can be attained by the multi-functional surgical device of the present invention. [029] Fig 3a) and 3b) illustrate mechanism for locking of indexable jaw member in the distal barrel of the multi-functional surgical device of the present invention.

[030] Fig 4a), 4b) and 4c) illustrates mechanism for locking of indexing knob in accordance with principles of the present invention.

[031 ] A better understanding of the objects, advantages, features, properties and relationships of the present invention will be obtained from the following detailed description which is indicative of the various ways in which the principles of the invention may be employed.

[032] DETAILED DESCRIPTION OF THE INVENTION

[033] In view of the foregoing disadvantages inherent in the prior art, the general purpose of the present invention, which will be described subsequently in greater detail, is to provide for construction and operation of a multi-functional minimally invasive surgical tool which has all the advantages of the prior art and none of the disadvantages.

[034] In this respect, before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not limited in its application to the details of construction and to the arrangements of the components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments and of being practiced and carried out in various ways. Also, it is to be understood that the phraseology and terminology employed herein are for the purpose of description and should not be regarded as limiting. [035] Hereinafter, subject to context presented, the word Ordinary" shall mean and refer to such construction and / or architecture most commonly observed and practiced in the art.

[036] To attain purpose of the present invention, attention is requested to accompanying Fig.1 a) which illustrates constructional features of the proposed surgical tool made in accordance with principles of the present invention. The indexable multifunctional surgical tool 000 comprises multifaceted jaw 001 mounted in housing 003 at distal end of outer tube 010 that can be rotationally indexed along its longer axis to achieve 2, 3, 4 or more positions. A centripetally closing pivotable jaw 004 is provided complementary to the indexable jaw 001 such that each indexation or orientation of the jaw 001 couples one of its facet profiles with the complementary surface of the jaw 004, thus allowing for a different surgical function chosen among grasping, scissoring, dissecting, needle driving and therefore, enables the multi-functionality of the proposed multifunctional surgical tool 000.

[037] According to another aspect of the present invention and specific reference to Fig 2 (a to d) and the schematics of Fig 1 (b to e), the jaw 001 achieves different surgical functions as result of surface profiles 013, 014, 015 and 016 which illustrate the configurations for fenestrated grasper, ordinary grasper, needle holder and scissor functionalities. Cauterization is intended to be covered in the present articulation via provision of suitable EMF. It shall be understood that these profiles are exemplary and may be replaced by any equivalents or those enabling other surgical functionalities without requiring to depart from the essence of the present invention.

[038] According to another aspect of the present invention and specific reference to Fig 1 a) and 3 (a and b), control over operation and manipulation of tool 000 is via combined effect of an near-distal profile element 009 on linear shaft 005 and the restricted operability of shaft 005 within housing 003. Suitable spring means are deployed within barrel 007 of stationary handle 008 forcing shaft 005 into cavity 006 inscribed within surface of housing 003 and extending substantially the height of element 009 into lumen of housing 003 such that element 009 locks into the cavity 006 upon default relaxed state of aforementioned spring means. The user may actuate the indexable jaw 001 via pulling out and rotating spring loaded index knob 01 1 which clicks into position when element 009 locks into the cavity 006 thus locking the tool 000 into an error free operational state. Pivotable jaw 004 may be then actuated via operation of pivot actuator 012 to attain among an open and closed state relative to facet of jaw 001 facing it. Motion of actuator 012 is unqualified, thus allowing the surgeon the freedom of tactile input necessary for operation being performed.

[039] According to another aspect of the present invention and specific reference to Fig. 4a), 4b) and 4c) the device of the present invention includes a further safety mechanism to prevent the incidental change in combinational configuration achieved between jaws 001 and 004. This is achieved by positioning of a locking element 018 capable of linear displacement from and within barrel of handle 007 which is further characterized in being attached to actuator 012 and juxtaposed beneath rotating spring loaded indexing knob 01 1 . Knob 01 1 bears orifices represented by 019 that allow selective coupling with element 018 to allow locking into each of the surgical configurations of the tool 000. This configuration makes possible rotation of the actuator 01 1 only when free from locking element 018. This event of the actuator 01 1 traveling beyond length of element 018 would only occur when the actuator 012 is released and the tool 000 is no longer in operation. It would be advantageous to add that construction of element 018 and number of orifices 019 may be modified in any way taught by any of the state of art locking systems. These are intended to be covered by essence of the present invention.

[040] It would be amply clear to the reader that the surgical tool proposed herein is capable of being operated via both manual and automated means, with the latter comprising electric motors such as servo motors, linear actuators and so on.

[041 ] Further embodiments of the present invention wherein either or both jaws among 001 and 004 of the tool 000 are indexable and/or pivotable or that a plurality of facets, up to 8 with presently available manufacturing methods, on a single jaw or a plurality of such jaws themselves implemented within said tool are intended to be covered by ambit of the present invention.

[042] The invention described herein is susceptible to variations, modifications and/or additions other than those specifically described and it is to be understood that the invention includes all such variations, modifications and/or additions which fall within the spirit and scope of the above description and appended claims.

Claims

We claim,

1 ] A multifunctional tool for use in minimally invasive surgery, said tool comprising:

^■ an effector unit 017 having at least one each among a multifaceted indexing jaw 001 and a pivotable jaw 004 for performing among a plurality of surgical functions at site of operation;

^■ an elongated hollow shaft 010 defining a longitudinal direction in extension with said effector unit 017 for encompassing mechanical linkages that allow effector unit 017 to access and perform at site of operation;

^■ integral means 003, 009, 018 and 019 for locking and maintaining said multifaceted jaw 001 in position corresponding to a particular surgical functionality;

^■ a handling unit 018 at other end of said longitudinal shaft 010 having at least one each among a grip 008, a first actuator 012, a locking element 019 and a second actuator 01 1 for performance and switching between the plurality of surgical functions intended.

2] The multifunctional tool for use in minimally invasive surgery according to claim 1 , wherein said jaw 001 comprises a plurality of facets on its outward lateral surfaces each corresponding to a unique surface profile dedicated for a particular surgical functionality.

3] The multifunctional tool for use in minimally invasive surgery according to claim 2, wherein said multifaceted jaw 001 comprises a plurality of profiles 013, 014, 015 and 016 machined on its successive outward lateral surfaces each corresponding to a particular surgical functionality chosen among fenestrated grasper, ordinary grasper, needle holder and scissor achieved upon closing in on either surface by the pivotable jaw 004.

The multifunctional tool for use in minimally invasive surgery according to claim 1 , wherein said integral means for locking said multifaceted jaw 004 in position is a coupling between profile element 009 on linear shaft 005 leading to the multifaceted jaw 001 and a cavity 006 matching profile of element machined into a collar housing 003 at distal end of shaft 005.

The multifunctional tool for use in minimally invasive surgery according to claim 3, wherein engagement between profile element 009 and cavity 006 maintains multifaceted jaw 001 in locked position under positive pressure of a spring housed in handling unit 018 the compression of which by a pulling out action on the second actuator 01 1 allows disengagement between profile element 009 and cavity 006 thereby allowing rotation of multifaceted jaw 001 into an intended surgical configuration.

The multifunctional tool for use in minimally invasive surgery according to claim 1 , wherein said grip 008 is chosen among conventionally available pistol grip, scissor grip and articulations suitable for mating with automated driving means.

The multifunctional tool for use in minimally invasive surgery according to claim 5, wherein automated driving means are chosen among electric motors and linear actuators. The multifunctional tool for use in minimally invasive surgery according to claim 1 , wherein selection among surface profiles 013, 014, 015 and 016 of multifaceted jaw 001 to meet the pivotable jaw 004 and thereby decide surgical functionality attained is by operation of a second actuator 01 1 housed in the handling unit and chosen among conventionally available turning knobs, buttons, trigger levers, toggle levers and switches.

The multifunctional tool for use in minimally invasive surgery according to claim 1 , wherein second actuator 01 1 is a spring- loaded rotatable knob with orifices represented by 019 in its profile to allow selectable locking in of any combinational configuration achieved between jaws 001 and 004.

The multifunctional tool for use in minimally invasive surgery according to claim 8 wherein selectable locking in of any combinational configuration achieved between jaws 001 and 004 is achieved by locking of element 018 in either of orifices represented by 019 in actuator 01 1 .

The multifunctional tool for use in minimally invasive surgery according to claim 8 wherein element 018 is linked to operation of first actuator 012 at point 020 characterized in that compression of actuator 012 causes element 018 to protrude to a length beyond travel of actuator 01 1 making impossible the change in surgical configuration when the tool 000 is in use.

The multifunctional tool for use in minimally invasive surgery according to claim 10 wherein release of said actuator 012 causes element 018 to ingress within barrel of body 007 making possible rotation of actuator 01 1 for change in surgical configuration when pulled to maximum travel permitted by associated spring.

The multifunctional tool for use in minimally invasive surgery according to claim 1 , wherein operation of pivotable jaw 004 among its open and closed positions is attained by operation of a second actuator 01 1 housed in the handling unit 018 and chosen among conventionally available turning knobs, buttons, trigger levers, toggle levers and switches.

The multifunctional tool for use in minimally invasive surgery according to claim 1 , wherein said multifaceted jaw 001 is pivotable for allowing larger freedom of movement.

The multifunctional tool for use in minimally invasive surgery according to claim 1 , wherein said mechanical linkages that allow pivotable jaw 004 to operate between its open and closed positions is chosen among conventionally available pivot joints and linear shafts.