US20080255413A1 - Powered surgical instrument - Google Patents

Abstract

A surgical instrument including a housing, an endoscopic portion, a shaft portion and an end effector is disclosed. The endoscopic portion extends distally from the housing and defines a longitudinal axis. The shaft portion is selectively connectable to a distal end of the endoscopic portion. The end effector is selectively connectable to a distal end of the shaft portion.

Description

CROSS REFERENCE TO RELATED APPLICATION
• This application is a continuation-in-part of U.S. patent application Ser. No. 11/786,934 filed on Apr. 13, 2007 by Zemlok, entitled “Powered Surgical Instrument,” the entire contents of which are hereby incorporated by reference herein.
BACKGROUND
• 1. Technical Field
• The present disclosure relates to surgical instruments for fastening body tissue and, more particularly, to a powered surgical instrument having a drive gear configured to be movable to affect rotation, articulation and actuation of the instrument.
• 2. Background of Related Art
• Surgical devices wherein tissue is first grasped or clamped between opposing jaw structure and then joined by surgical fasteners are well known in the art. In some instruments, a knife is provided to cut the tissue which has been joined by the fasteners. The fasteners typically include surgical staples and two part polymeric fasteners.
• Instruments for this purpose may include two elongated members which are respectively used to capture or clamp tissue. Typically, one of the members carries a staple cartridge that houses a plurality of staples arranged in rows while the other member has an anvil that defines a surface for forming the staple legs as the staples are driven from the staple cartridge. Several instruments include clamps, handles and/or knobs to affect actuation along with rotation and articulation of an end effector. Such surgical instruments can require the user to exert a significant force in operating the handles, knobs, etc., and require more than one hand to operate the instrument.
• Surgical instruments with actuators that require less force to operate are desired. In addition, surgical instruments which perform multiple functions with one-handed operation are also desired.
SUMMARY
• The present disclosure relates to a surgical instrument including a housing, an endoscopic portion, a drive gear, a drive motor, a shift motor and an end effector. The endoscopic portion extends distally from the housing and defines a longitudinal axis. The drive gear is disposed at least partially within the housing and is rotatable about a drive gear axis which extends therethrough. The drive gear is selectively movable along the drive gear axis. The drive motor is disposed in mechanical cooperation with the drive gear and is configured to rotate the drive gear. The shift motor is disposed in mechanical cooperation with the drive gear and is configured to move the drive gear along the drive gear axis. The end effector is disposed adjacent a distal portion of the endoscopic portion.
• The present disclosure also relates to a method of applying surgical fasteners to tissue. The method of this embodiment includes providing a powered surgical instrument which includes a housing, an endoscopic portion, a drive gear and an end effector. The endoscopic portion extends distally from the housing and defines a longitudinal axis. The drive gear is disposed at least partially within the housing and is rotatable about a drive gear axis extending therethrough. The drive gear is selectively movable along the drive gear axis. The end effector is disposed adjacent a distal portion of the endoscopic portion. The method further includes moving the drive gear along the drive gear axis and rotating the drive gear about the drive gear axis.
DESCRIPTION OF THE DRAWINGS
• An embodiment of the presently disclosed powered surgical instrument is disclosed herein with reference to the drawings, wherein:
• FIG. 1 is a perspective view of a powered surgical instrument according to an embodiment of the present disclosure;
• FIG. 2 is an enlarged partial perspective view of the powered surgical instrument ofFIG. 1;
• FIG. 3 is an enlarged partial perspective view of the powered surgical instrument ofFIGS. 1 and 2;
• FIG. 4 is a partial perspective sectional view of internal components of the powered surgical instrument ofFIGS. 1-3 in accordance with an embodiment of the present disclosure;
• FIGS. 5 and 6 are partial perspective sectional views showing the internal components of the powered surgical instrument ofFIGS. 1-4 disposed in a first position;
• FIG. 7 is a cross-sectional view of the internal components of the powered surgical instrument ofFIGS. 1-5 disposed in a second position;
• FIG. 8A is a partial perspective view including an endoscopic portion of the powered surgical instrument ofFIGS. 1-7 according to an embodiment of the present disclosure;
• FIG. 8B is an enlarged perspective view of a portion of the powered surgical instrument indicated inFIG. 8A;
• FIGS. 9-11 are partial perspective sectional views of the internal components of the powered surgical instrument ofFIGS. 1-8 disposed in a third position;
• FIGS. 12 and 13 are enlarged perspective views of portions of the powered surgical instrument ofFIGS. 1-11 according to an embodiment of the present disclosure;
• FIG. 14 is a cross-sectional view of a portion of a powered surgical instrument including a handle portion according to an embodiment of the present disclosure;
• FIGS. 15A-B are perspective views of an articulating shaft of the distal portion of the powered surgical instrument ofFIG. 1 according to an embodiment of the present disclosure;
• FIG. 16 is a perspective view of a powered surgical instrument having a selectively connectable shaft portion according to an embodiment of the present disclosure;
• FIGS. 17A-17C are each perspective views of end effector having circular staple cartridges engaged with a shaft portion, each shaft portion being connectable with the powered surgical instrument ofFIG. 16;
• FIG. 18 is a perspective view of an end effector having parallel jaw member engaged with a shaft portion, the shaft portion being connectable with the powered surgical instrument ofFIG. 16; and
• FIG. 19 is a rear perspective view of the powered surgical instrument ofFIG. 16.
DETAILED DESCRIPTION OF EMBODIMENTS
• Embodiments of the presently disclosed powered surgical instrument are now described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein the term “distal” refers to that portion of the powered surgical instrument, or component thereof, farther from the user while the term “proximal” refers to that portion of the powered surgical instrument or component thereof, closer to the user.
• A powered surgical instrument, e.g., a surgical stapler, in accordance with the present disclosure is referred to in the figures asreference numeral100. Referring initially toFIG. 1, poweredsurgical instrument100 includes ahousing110, anendoscopic portion140 defining a longitudinal axis A-A extending therethrough, and anend effector160, defining a longitudinal axis B-B (illustrated substantially aligned with axis A-A inFIG. 1) extending therethrough.Endoscopic portion140 extends distally fromhousing110 andend effector160 is disposed adjacent adistal portion142 ofendoscopic portion140.
• With reference toFIGS. 2 and 3, an enlarged view ofhousing110 is illustrated according to an embodiment of the present disclosure. In the illustrated embodiment,housing110 includes ahandle portion112 having at least onebutton114 thereon (twobuttons114aand114bare shown).Handle portion112, which defines a handle axis H-H, is shown havingindentations116 that correspond to fingers of a user. Eachbutton114aand114bis shown as being disposed on anindentation116 to facilitate its depression by a user's finger.
• With continued reference toFIGS. 2 and 3, aproximal area118 ofhousing110 includes auser interface120. In the illustrated embodiment,user interface120 includes ascreen122 and at least one switch124 (sevenswitches124a-124gare shown).Screen122 displays readable information thereon, including status information of poweredsurgical instrument100 in an embodiment.Switches124a-124gcontrol various actions of poweredsurgical instrument100, as is described in detail below.
• FIGS. 4-7,9-11 and14 illustrate various internal components of poweredsurgical instrument100, including adrive gear200 or drive member, adrive motor210 and ashift motor220. It is envisioned that a three-position solenoid, for instance, can be used as an alternative to shiftmotor220.Drive gear200 is rotatable about a drive gear axis C-C extending therethrough (FIG. 4) and is selectively movable along drive gear axis C-C.Drive motor210 is disposed in mechanical cooperation withdrive gear200 and is configured to rotatedrive gear200 about drive gear axis C-C.Shift motor220 is disposed in mechanical cooperation with drive gear200 (drivemotor210 is illustrated betweendrive gear200 and shiftmotor220 in accordance with a disclosed embodiment) and is configured to translatedrive gear200 axially along drive gear axis C-C. In a disclosed embodiment, drivemotor210 and/or shiftmotor220 may be a motor or a gear motor, which may include gearing incorporated within its housing.
• Shift motor220 is configured to selectively movedrive gear200 between a plurality of positions; three positions are shown in the illustrated embodiments. The first position, illustrated inFIGS. 5 and 6, enables rotation ofend effector160; the second position, illustrated inFIG. 7, enables articulation ofend effector160; and the third position, illustrated inFIGS. 9-11 and14, enables actuation of poweredsurgical instrument100.
• A cut-away view ofdrive motor casing212, surroundingdrive motor210, is illustrated inFIGS. 4-7,9-10 and14. Drivemotor casing212 includes a plurality of slots214 (threeslots214a,214band214care illustrated) therein. Each slot214 is matable with aposition lock216 to maintaindrive gear210 in a desired position. For example, inFIG. 5,position lock216 is shown mated with slot214a-corresponding to drivegear200 being in its first position. InFIG. 7,position lock216 is shown mated withslot214b—corresponding to drivegear200 being in its second position.FIGS. 9,10 and14 illustrateposition lock216 mated withslot214c—corresponding to drivegear200 being in its third position.Position lock216, in the illustrated embodiments, is spring-loaded towardsdrive motor casing212, which helps place and maintaindrive motor210 is a desired position.
• In the illustrated embodiments,shift motor220 is located proximally ofdrive motor210 and is configured to translatedrive motor210 along drive gear axis C-C between its first, second and third positions. Referring toFIG. 10,shift motor220 is illustrated as driving ashift screw222 in conjunction with an internally-threaded screw housing223 (seeFIG. 10), in accordance with a disclosed embodiment. It is further disclosed that a shift sensor224 (seeFIG. 4) (e.g., micro switch or optical/ferromagnetic proximity sensor activated by position lock216), disposedadjacent position lock216, electrically communicates with at least oneswitch124 to start or stopshift motor220 and/or provides feedback relating to the position ofdrive motor210, for example the mode of operation for poweredsurgical instrument100 is desirably displayed onscreen122. For instance, the position ofdrive motor210 may be indicated onscreen122 ofuser interface120.
• With reference toFIGS. 5 and 6, the first position ofdrive gear200 is illustrated. Here, aring gear230 or rotation member is disposed withinhousing110 and rotation ofring gear230 causes rotation ofendoscopic portion140,end effector160 and adistal housing portion110aof poweredsurgical instrument100. It is envisioned that an inner surface ofring230 includes threads and/or teeth to engagedrive gear200, and is attached todistal housing portion110a, which is disposed distally of aproximal housing portion110b. Further,distal housing portion110ais rotatable with respect toproximal housing portion110bvia a peripherally disposedchannel232 disposed withindistal housing portion110aand a corresponding peripherally disposedflange234 disposed withinproximal housing portion110b.
• In an embodiment,ring gear230 is rigidly secured withindistal housing portion110aand is matingly engagable withdrive gear200. Thus, rotation ofdrive gear200 causesring gear230, and thusdistal housing portion110ato rotate. InFIG. 2, alip235 is shown which isolates a user's hand from rotatabledistal housing portion110a. It is envisioned that a plurality of washers or ball-bearings (possibly made from synthetic resinous fluorine-containing polymers sold under the trademark Teflon®) are disposed betweendistal housing portion110aandproximal housing portion110bto reduce the rotational friction therebetween.
• With continued reference to the embodiment illustrated inFIG. 6, a plurality ofdetents231 is disposed around asurface233 ofdistal housing portion110a. Atab237 is shown disposed onproximal housing portion110band may comprise a pawl or spring-biased member. In a disclosed embodiment,tab237 is distally biased and in mechanical cooperation with at least one of plurality ofdetents231. The combination ofdetents231 andtab237 helps securedistal housing portion110ain a rotational position with respect toproximal housing portion110b. Further,detents231 andtab237 may be provided to give the user audible and/or tactile feedback whenendoscopic portion140 is rotated. In a disclosed embodiment, a three-position solenoid may be used to lock the rotational position ofend effector160 once the desired rotational position is selected.
• InFIG. 7,drive gear200 is illustrated in its second position, asposition lock216 is aligned withslot214b. Here,drive gear200 is matingly engaged with anarticulation gear240, which is disposed at least partially withinhousing110. Rotation ofarticulation gear240 causesend effector160 to move from its first position, where longitudinal axis B-B is substantially aligned with longitudinal axis A-A, towards a position in which longitudinal axis B-B is disposed at an angle to longitudinal axis A-A. Preferably, a plurality of articulated positions are achieved.
• In the illustrated embodiments and with specific reference toFIGS. 7 and 8, articulation ofend effector160 is affected by anarticulation gear240, anarticulation screw242, anarticulation linkage244 and at least onearticulation rod260. More specifically,articulation gear240 is rigidly mounted toarticulation screw242, such that asarticulation gear240 is rotated by rotation ofdrive gear200 while in its second position,articulation screw242 also rotates. A plurality ofbearings262 is illustrated at various locations onarticulation screw242 to facilitate the retaining and aligning ofarticulation screw drive242 as well as reducing the friction betweenarticulation screw242 andhousing110, for example.
• With continued reference toFIG. 7,articulation screw242 includes a threadedportion246, which extends through an internally-threadedportion248 ofarticulation linkage244. This relationship betweenarticulation screw242 andarticulation linkage244 causesarticulation linkage244 to move distally and/or proximally (in the directions of arrows D and E) along threadedportion246 ofarticulation screw242 upon rotation ofarticulation screw242. For example, asarticulation screw242 rotates in a first direction (e.g., clockwise),articulation linkage244 move proximally, and asarticulation screw242 rotates in a second direction (e.g., counter-clockwise),articulation linkage244 move distally.
• At least onearticulation arm250 is shown extending fromarticulation linkage244. In an embodiment,articulation arm250 is rigidly connected toarticulation rod260 and it is envisioned that more than onearticulation arm250 is connectable to more than onearticulation rod260. Asarticulation linkage244 is translated distally and/or proximally in response to rotation ofarticulation gear240, articulation rod(s)260 is also translated distally and/or proximally (in the directions of arrows F and G, along longitudinal axis A-A) in response thereto. Any combinations of limits switches, proximity sensors (e.g., optical and/or ferromagnetic), linear variable displacement transducers and shaft encoders (disposed withinhousing110, for instance) may be utilized to control and/or record the location ofarticulation linkage244 and/or articulation angle ofend effector160 and/or position of a firing rod306 (as discussed below with reference toFIGS. 9 and 11).
• With reference toFIGS. 8A and 8B,articulation rod260 is shown extending through at least a portion ofendoscopic portion140 and in mechanical cooperation with alinkage rod264. Thus,linkage rod264 similarly moves along longitudinal axis A-A upon rotation ofarticulation gear240. Adistal portion266 oflinkage rod264 is in mechanical cooperation withend effector160, such that proximal and distal movement oflinkage rod264 causesend effector160 to move from its first position towards its second position about pivot P. For example,linkage rod264 is connected to endeffector160 at a location offset laterally from pivot P. More specifically, and for illustrative purposes, aslinkage rod264 moves distally,end effector160 is articulated in the direction of arrow H and aslinkage rod264 is translated proximally,end effector160 is articulated in the direction of arrow I. It is also envisioned that a portion ofarticulation rod260 is in mechanical cooperation withend effector160 to affect articulation thereof. Further details of providing articulation to endeffector160 are described in detail in commonly-owned U.S. Pat. No. 6,953,139 to Milliman et al., the contents of which are hereby incorporated by reference in their entirety.
• According to an embodiment of the present disclosure,end effector160 includes a cartridge assembly (e.g., jaw member164) and an anvil assembly (e.g., jaw member162) including an anvil portion for deploying surgical fasteners into body tissue and forming the surgical fasteners.End effector160 is pivotably mounted about an axis substantially perpendicular to the longitudinal axis ofendoscopic portion140.Cartridge assembly164 houses a plurality of staples.Anvil assembly162 is movable in relation tocartridge assembly164 between an open position spaced fromcartridge assembly164 and an approximated or clamped position in juxtaposed alignment withcartridge assembly164. Preferably, the staples are housed incartridge assembly164 to apply linear rows of staples to body tissue.End effector160 is attached to a mounting portion, which is pivotably attached to a body portion. The body portion may be integral withendoscopic portion140 of poweredsurgical instrument100, or may be removably attached thereto to provide a replaceable or disposable loading unit. The loading unit may be connectable toendoscopic portion140 through a bayonet connection. It is envisioned that the loading unit has an articulation link connected to the mounting portion of the loading unit and the articulation link is connected to the linkage rod so that theend effector160 is articulated as the linkage rod is translated in the distal-proximal direction along the longitudinal axis. Other means of connectingend effector160 toendoscopic portion140 to allow articulation may be used. For example, a flexible tube or a plurality of pivotable members may be used.
• A loading unit may incorporate (or be configured to incorporate) various end effectors, such as vessel sealing devices, linear stapling devices, circular stapling devices, cutters, etc. Such end effectors may be coupled toendoscopic portion140 of poweredsurgical instrument100. An intermediateflexible shaft500 may be included betweenhandle portion112 and loading unit. For example, as shown inFIGS. 15A-B, endoscopic anddistal portions140,142 are shown as aflexible shaft500.Flexible shaft500 includes a plurality of interconnected angledouter tubes501 and502.FIG. 15A shows flexible shaft in a non-articulated formation andFIG. 15B showsflexible shaft500 in an articulated formation. Whenflexible shaft500 is straight, narrow sections oftubes501 alternate with the wide sections oftubes502 as shown inFIG. 15A. Whenflexible shaft500 is fully articulated, the short sides and the wide sides oftubes501 and502 are aligned, as shown inFIG. 15B. Such aflexible shaft500 may facilitate access in certain areas of the body.
• Further, where various loading units can be used, a digital control module (DCM)130 (FIG. 4) can control the force being applied torod306 so thatrod306 can drive the particular end effector that is on the loading unit in use at the time. For clarity, wires are not shown in theFigures connecting DCM130 to various components of poweredsurgical instrument100, but such wires are contemplated by the present disclosure. The loading unit may also include a mechanical or electronic sensor that indicates toDCM130 which end effector is on the loading unit. In an embodiment,DCM130 is also capable of storing information relating to the force applied torod306. Additionally, the voltage and current fromdrive motor210 may be measured to provide information and/or feedback regarding the state of poweredsurgical instrument100. For instance, if the user is attempting to clamp down on tissue that is too thick, the voltage and/or current will increase. This information can be provided to the user and/or the power can be interrupted or ceased. It is envisioned that such a feature helps prevent damage to the mechanisms in the instrument.
• With reference toFIGS. 9-11 and14,drive gear200 is illustrated in its third position, withposition lock216 aligned withslot214c. Here,drive gear200 is matingly engaged with anactuator gear300, which is disposed at least partially withinhousing110. More specifically, a set ofteeth202 disposed on a face204 (FIG. 4) ofdrive gear200 matingly engage teeth onactuator gear300 to provide at least one of grasping tissue, clamping tissue, and firing of end effector160 (e.g., stapling and cutting) and retracting elements to their original position.
• With continued reference toFIGS. 9 and 11, adrive tube302, abung304 and firingrod306 are also included. Drivetube302 includes internal threads (not explicitly shown) along at least a portion of its length and is rigidly attached toactuator gear300.Bung304 is threadably engaged with internal threads ofdrive tube302 and is translatable withindrive tube302 with respect toactuator gear300.FIG. 9 shows bung304 near its proximal-most position andFIG. 11 illustratesbung304 near its distal-most position. Firingrod306 is rigidly connected to bung304 and extends distally therefrom. In an embodiment of the disclosure, firingrod306 extends at least todistal portion142 ofendoscopic portion140.
• In response to rotation ofdrive gear200,actuator gear300 and drivetube302 also rotate. Asdrive tube302 rotates,bung304 and firingrod306 are translated proximally and/or distally within the confines ofdrive tube302. Distal translation of firing rod306 (corresponding with a clockwise rotation ofdrive gear200, for instance) can causejaw members162,164 (seeFIG. 1) ofend effector160 to grasp or clamp tissue held therebetween. Additional distal translation of firingrod306 may cause surgical fasteners to be ejected from end effector160 (e.g., via cam bars and/or an actuation sled (neither of which are explicitly shown in this embodiment)) to fasten tissue and may also cause a knife (not explicitly shown in this embodiment) to sever tissue. Proximal translation of firing rod306 (corresponding with a counter-clockwise rotation ofdrive gear200, for instance) can causejaw members162,164 and/or knife to return to their pre-fired positions. Further details of firing and otherwise actuatingend effector160 are described in detail in commonly-owned U.S. Pat. No. 6,953,139 to Milliman et al., the entire contents of which are hereby incorporated by reference herein.
• In an embodiment of the disclosure, the anvil portion ofend effector160 includes a cam surface for being engaged by the drive assembly ofend effector160. The drive assembly includes a drive beam, which desirably has a knife for cutting tissue. The drive beam has a cam roller positioned to engage the cam surface, and a flange positioned to engage the cartridge assembly to effect approximation of theanvil assembly162 andcartridge assembly164 with respect to one another when the drive beam is advanced distally. In addition, when advanced further in the distal direction, the drive beam engages an actuation member for deploying the surgical fasteners from the cartridge assembly, as disclosed in the Milliman '139 patent.
• Any combination of sensors may be positioned within poweredsurgical instrument100 to determine the position of various components and/or its operating stage, e.g., articulation, rotation, clamping, firing ofend effector160. For example, limit switches, proximity sensors (e.g., linear and/or ferromagnetic), potentiometers, linear variable displacement transducers (LVDT), shaft encoders, etc., may be used to help control and/or record the location ofarticulation linkage244, firingrod306 and/orring gear230, as discussed above.
• Referring now toFIGS. 9,11 and12,endoscopic portion140 includes atube housing144 that extends from an areaadjacent housing110 towardsend effector160. Asdrive tube302 rotates,end effector160 does not rotate as a direct consequence thereof. Referring toFIG. 13,tube housing144 includesflat portions148 thereon, which correspond toflat portions310 of firingrod306. The pair offlat portions148 and310 helps prevent rotation of firingrod306 by helping to limit firingrod306 to axial movement.
• With reference toFIG. 9, adrive motor shaft218 is shown extending fromdrive motor210 and being connected to drivegear200. A fastener (not explicitly shown in this embodiment) may be used to retaindrive gear220 ondrive motor shaft218. Drivemotor shaft218 is rotated bydrive motor210, thus resulting in rotation ofdrive gear220. Drivemotor shaft218 is shown having a flat portion219 (more than oneflat portions219 may be included), which allows “play” or “rotational float” betweendrive gear220 and drivemotor shaft218 to facilitate tooth alignment of the gears and to help enabledrive gear220 to shift between positions.FIG. 9 also illustrates abearing308 disposed withinhousing110 and at least partially surroundingdrive tube302. Bearing308 facilitates rotation ofdrive tube302 and helps to aligndrive tube302 throughendoscopic portion140 and supports all thrust loading betweendrive gear200 andactuator gear300.
• InFIG. 10, atransducer420 is shownadjacent drive motor210 and shiftmotor220. Transducer420 (e.g., a force or pressure transducer) may measure and/or control the force required for the desired pressure onactuator gear300.Transducer420 may be in communication with portions ofuser interface120, which may provide feedback to a user. Additionally,spring coupling430 is illustrated betweendrive motor210 and shiftmotor220. Specifically, in a disclosed embodiment,spring coupling430 includes aspring432 mounted in atelescoping cage434.Shift screw222 is shown extending throughspring432 and may be configured to apply a compressive load onspring432. It is envisioned thatcage434 is collapsible asspring432 is compressed. The force applied to drivemotor210 may be adjusted usingspring432 and/orcage434.
• In an embodiment of the disclosure,drive gear200 andactuator gear300 form a clutch face. The gear teeth are arranged to slip unless a threshold force is applied to drivemotor210 byshift motor200 and a spring coupling430 (as discussed below in connection withFIG. 10) disposed therebetween. Further, whenshift motor200 andspring coupling430 apply the threshold force needed fordrive gear200 andactuator gear300 to engage without slipping,rod306 will be driven distally. Telescopingcage434 may include a stop incorporated therewith, such thatcage434 will retractrod306, rather than decompressspring coupling430.
• With reference toFIG. 3,user interface120 is shown includingscreen122 and sevenswitches124a-124g. In the illustrated embodiment, user interface displays the “mode” (e.g., rotation, articulation or actuation), which may be communicated touser interface120 via shift sensor224 (FIG. 4), “status” (e.g., angle of articulation, speed of rotation, or type of actuation) and “feedback,” such as whether staples have been fired. Switch124ais shown having an “M,” standing for mode, which may be used to positiondrive gear200 viashift motor220 for selecting between rotation, articulation, grasping, clamping and firing. It is also envisioned thatswitch124acan be used to let a user input different tissue types, and various sizes and lengths of staple cartridges.
• Switches124b-124eonuser interface120 are shown with arrows thereon and may be used for selecting the direction, speed and/or torque at which drivegear200 is rotated bydrive motor210. It is also envisioned that at least oneswitch124 can be used for selecting an emergency mode that overrides various settings, for example. Further, switches124fand124gare illustrated having an “N” and a “Y” thereon. It is envisioned thatswitches124fand124gmay be used for helping a user navigate and select various setting of poweredsurgical instrument100. The indicia onswitches124a-124gand their respective functions are not limited by what is shown in the accompanying figures, as deviations therefrom are contemplated and within the scope of the present disclosure. Additionally, and with reference toFIGS. 1 and 2,buttons114aand114bmay be used for starting and/or stopping movement ofdrive motor210 and/or shiftmotor220. Other functions forbuttons114 and114bare also anticipated as well as having more orfewer buttons114. In a particular embodiment,switches124a-124gmay include one or more microelectronic membrane switches, for example. Such a microelectronic membrane switch includes a relatively low actuation force, small package size, ergonomic size and shape, low profile, the ability to include molded letters on the switch, symbols, depictions and/or indications, and a low material cost. Further,switches124a-124g(such as microelectronic membrane switches) may be sealed to help facilitate sterilization of poweredsurgical instrument100, as well as helping to prevent particle and/or fluid contamination.
• As an alternative to, or in addition toswitches124 orbuttons114, other input devices may include voice input technology, which may include hardware and/or software incorporated in a digital control module (DCM)130 (FIG. 4), or a separate digital module connected toDCM130. The voice input technology may include voice recognition, voice activation, voice rectification and/or embedded speech. The user may be able to control the operation of the instrument in whole or in part through voice commands, thus freeing one or both of the user's hands for operating other instruments. Voice or other audible output may also be used to provide the user with feedback.
• In an embodiment,spring coupling430 is used in the feedback and control of poweredsurgical instrument100. As described above,DCM130 may be connected to one ormore buttons114 orswitches124 and one ormore display screens122 to provide feedback to the user and for helping to control the operation of poweredsurgical instrument100.DCM130 may be a digital board incorporated inhousing110 of poweredsurgical instrument100.Spring coupling430 may include a pressure transducer that can interact withDCM130 to control the force being applied torod306.
• It is also envisioned thatuser interface120 includes different colors and/or intensities of text onscreen122 and/or onswitches124a-124gfor further differentiation between the displayed items. User feedback can also be included in the form of pulsed patterns of light, acoustic feedback (e.g., buzzers, bells or beeps that may be sounded at selected time intervals), verbal feedback, and/or haptic vibratory feedback (such as an asynchronous motor or solenoids), for example. The visual, auditory or haptic feedback can be increased or decreased in intensity. For example, the intensity of the feedback may be used to indicate that the forces on the instrument are becoming excessive. Additionally,switches124a-124gmay be positioned at different heights from one another and/or may included raised indicia or other textural features (e.g., concavity or convexity) to allow a user to depress anappropriate switch124 without the need to look atuser interface120. Further,proximal housing portion110bmay be used as a joy stick-type control system.
• Additionally,user interface120 may include a separate display screen orscreens122 and input devices (such asswitches124 or buttons114), or the input devices may be incorporated in whole or in part inscreen122. For example, a touch screen liquid crystal display (LCD) may be used to allow the user to provide input while viewing operational feedback. The touch screen LCD may include resistive, capacitive or surface acoustic wave controls. This approach may enable facilitation of sealingscreen122 components to help sterilize poweredsurgical instrument100, as well as preventing particle and/or fluid contamination. In certain embodiments,screen122 is pivotably or rotatably mounted to poweredsurgical instrument100 for flexibility inviewing screen122 during use or preparation.Screen122 may be hinged or ball-and-socket mounted to poweredsurgical instrument100, for example.
• In a disclosed embodiment, at least some of the information monitored by the various sensors in poweredsurgical instrument100 may be provided to a video screen or monitoring system in an operating room. For instance, the data may be transmitted to a receiver for the operating room monitoring system from a communication transmitter incorporated in or associated with poweredsurgical instrument100, via technology including Blue Tooth, ANT3, KNX, Z Wave, X10, wireless USB, WiFi, IrDa, Nanonet, Tiny OS, ZigBee, radio, UHF and VHF. Such features may facilitate monitoring by the user of poweredsurgical instrument100 or other operating room or hospital personnel or remotely located persons.
• Referring toFIG. 4, any combination of abattery pack400, fuel cell and/or high-energy capacitor may be used to provide power to poweredsurgical instrument100. For example, capacitors may be used in conjunction withbattery pack400. Here, capacitors can be used for a burst of power when energy is desired/required more quickly than can be provided with a battery on its own (e.g., when clamping thick tissue, rapid firing, clamping, etc.), as batteries are typically slow-drain devices from which current cannot be quickly drawn. It is envisioned that batteries can be connected to capacitors to charge the capacitors.
• It is also envisioned thatbattery pack400 includes at least one disposable battery. The disposable battery may be between about 9 volts and about 30 volts and may be useful in a disposable surgical instrument. Other power-supplying means are also contemplated including electric power. In alternative embodiments a cord is provided to connectinstrument100 to a generator.
• In a disclosed embodiment, the DCM is connected to shiftmotor220 and drivemotor210 and is configured and arranged to monitor thebattery400 impedance, voltage, temperature and/or current draw and to control the operation of poweredsurgical instrument100. The load or loads onbattery400, transmission,motors220,210 and drive components of poweredsurgical instrument100 are determined to control a motor speed if the load or loads indicate a damaging limitation is reached or approached. For example, the energy remaining inbattery400, the number of firings remaining, whetherbattery400 must be replaced or charged, and/or approaching the potential loading limits of poweredsurgical instrument100 may be determined.
• The DCM can be configured and arranged to control or help control the operation ofshift motor220 and/or drivemotor210 to respond to the monitored information. Pulse modulation, which may include an electronic clutch, may be used in controlling the output. For example, the DCM can regulate the voltage or pulse modulate the voltage to adjust the power and/or torque output to prevent system damage or optimize energy usage. An electric braking circuit may be used for controllingdrive motor210 and/or shiftmotor220, which uses the existing back electromotive force (EMF) of rotatingdrive motor210 to counteract and substantially reduce the momentum ofdrive gear200. The electric braking circuit may improve the control ofdrive motor210 and/or shiftmotor220 for stopping accuracy and/or shift location of poweredsurgical instrument100. Sensors for monitoring components of poweredsurgical instrument100 and to help prevent overloading of poweredsurgical instrument100 may include thermal-type sensors, such as thermal sensors, thermistors, thermopiles, thermo-couples and/or thermal infrared imaging and provide feedback to the DCM. The DCM may control the components of poweredsurgical instrument100 in the event that limits are reached or approached and such control can include cutting off the power from thebattery pack400, temporarily interrupting the power or going into a pause mode, pulse modulation to limit the energy used, and the DCM can monitor the temperature of components to determine when operation can be resumed. The above uses of the DCM may be used independently of or factored with current, voltage, temperature and/or impedance measurements.
• In the embodiment illustrated inFIG. 5,shift motor220 is shown including a two-part housing226. Eachpart226aand226bof two-part housing226 are slidably engaged with each other. It is envisioned thatpart226ais rigidly secured to drivemotor casing212, whilepart226bis affixed to shiftmotor220 and is translatable withinhousing110. Additionally, awiring slot228 may be included to allow for wires (not explicitly shown in this embodiment) to pass fromtransducer420 towardsuser interface120, for example (see alsoFIG. 10).
• Referring toFIG. 14, poweredsurgical instrument100 is illustrated having a pistol-grip handle portion112. Here,handle portion112 is disposed at an angle (e.g., substantially 90°) from longitudinal axis A-A. In this embodiment, it is envisioned that at least onebutton114 is disposed thereon. Additionally,user interface120 may be positioned approximately in the position shown inFIG. 14. Further, a movable handle (not explicitly shown in this embodiment) may be employed to control various functions of poweredsurgical instrument100.
• It is envisioned thatend effector160 is reusable, can accept a staple cartridge and/or is part of a disposable loading unit. Further details of a disposable loading unit are described in detail in commonly-owned U.S. Pat. No. 5,752,644 to Bolanos et al., the entire contents of which are hereby incorporated by reference herein. Disposable and/or replaceable loading units can include end effectors without articulation, as disclosed in U.S. Pat. No. 6,953,139 to Milliman et al., previously incorporated by reference. A switch may be providedadjacent handle portion112 to deactivate the second position ofshift motor220 electronically. Other means, such as mechanical means, may also be used.
• A disposable or replaceable loading unit incorporating asurgical end effector160, in certain embodiments of the present disclosure, includes sensors positioned within the loading unit to determine the position of various components and/or operation ofend effector160, such as articulation, rotation, clamping and firing ofend effector160. For example, electrical contacts, proximity sensors, optical sensors, photo diodes, and/or mechanical or metallic sensors are used to control and/or record information concerning theend effector160. The location of theanvil assembly162 andcartridge assembly164 with respect to one another, the articulated or non-articulated position ofend effector160, rotation ofend effector160, and/or correct loading of the loading unit, staple cartridge and/or components of the staple cartridge may also be determined.
• An identification system may also be included to determine and communicate to the DCM various information, including the speed, power, torque, clamping, travel length and strength limitations for operating theparticular end effector160. The DCM may also determine the operational mode and adjust the voltage, clutch spring loading and stop points for travel of the components. More specifically, the identification system may include a component (e.g., a microchip, emitter or transmitter) inend effector160 that communicates (e.g., wirelessly, via infrared signals, etc.) with the DCM, or a receiver therein. It is also envisioned that a signal may be sent via firingrod306, such that firingrod306 functions as a conduit for communications between the DCM andend effector160.
• The loading unit, in certain embodiments according to the present disclosure, includes an axial drive assembly that cooperates with firingrod306 toapproximate anvil assembly162 andcartridge assembly164 ofend effector160, and fire staples from the staple cartridge. The axial drive assembly may include a beam that travels distally through the staple cartridge and may be retracted after the staples have been fired, as disclosed in certain embodiments of U.S. Pat. No. 6,953,139 to Milliman et al., the disclosure of which is hereby incorporated by reference herein. By way of example, the sensors discussed above may be used to determine if the staples have been fired from the staple cartridge, whether they have been fully fired, whether and the extent to which the beam has been retracted proximally through the staple cartridge and other information regarding the operation of the loading unit. In certain embodiments of the present disclosure, the loading unit incorporates components for identifying the type of loading unit, and/or staple cartridge loaded on theinstrument100, including infra red, cellular, or radio frequency identification chips (such as Sensormatic or similar technology). The type of loading unit and/or staple cartridge may be received by an associated receiver within the DCM, or an external device in the operating room for providing feedback, control and/or inventory analysis. The power orbattery pack400 can incorporate a component for identifying the type ofpower pack400 loaded with poweredsurgical instrument100 or for sending feedback concerning the status ofpower pack400.
• In certain embodiments of the present disclosure, poweredsurgical instrument100 includes disposable or replaceable loading units incorporating asurgical end effector160 and a reusable portion including ahousing110 andendoscopic portion140 that is removably attached to the loading unit. The reusable portion may be configured for sterilization and re-use in a subsequent surgical procedure. In an embodiment, the components of thehousing110 are sealed against infiltration of particulate and/or fluid contamination and help prevent damage of the component by the sterilization process.Power pack400, in certain embodiments according to the present disclosure, comprises a rechargeable battery. The rechargeable battery can be connected to contacts accessible athousing110 of theinstrument100, for example, or, rechargeable battery may be rechargeable through an inductive charging interface sealed withinhousing110. The inductive charging interface may eliminate shorting of contacts and provides an internal battery that may be hermetically or liquid resistance sealed.
• The present disclosure also relates to a method of applying surgical fasteners to tissue. The method includes the use of poweredsurgical instrument100, as described above.
• Now referring toFIGS. 16-19, a powered surgical instrument, e.g., a surgical stapler, in accordance with other embodiments of the present disclosure is referred to asreference numeral1000. Poweredsurgical instrument1000 includes ahousing1100, anendoscopic portion1400 defining a first longitudinal axis D-D extending therethrough, ashaft portion1500 and anend effector1600 defining a second longitudinal axis E-E extending therethrough. Further details of poweredsurgical instrument 1000 are included in U.S. patent application Ser. No. 11/786,933 (H-US 00977; 203-5562), the entire contents of which are hereby incorporated by reference herein. While the features of the embodiments illustrated inFIGS. 16-19 are shown in connection with a particular type ofsurgical instrument1000, it is envisioned that the features described with respect toFIGS. 16-19 are operable with other surgical instruments, such as poweredsurgical instrument100 ofFIGS. 1-15.
• With continued reference toFIG. 16,endoscopic portion1400 extends distally fromhousing1100,shaft portion1500 is selectively connectable to adistal end1402 ofendoscopic portion1400 andend effector1600 is selectively connectable to adistal end1502 ofshaft portion1500. As shown inFIGS. 16-18, a plurality ofdifferent shaft portions1500 may be used withsurgical instrument1000 and a plurality ofdifferent end effectors1600 may also be used withsurgical instrument1000.
• More specifically, a plurality ofdifferent shaft portions1500 may be removably connectable toendoscopic portion1400, e.g., for a particular purpose. It is envisioned that at least a portion ofshaft portion1500 may be articulatable (FIG. 17A), curved (FIG. 17B) or made from a compliant material (such as, for example, as illustrated inFIG. 17C).
• As shown inFIGS. 16-18, a plurality of different classes ofend effectors1600 may be removably connectable toshaft portion1500 ofsurgical instrument1000. It is envisioned that classes ofend effectors1600 that are selectively connectable todistal end1502 ofshaft portion1600 include those having a pivotable cartridge assembly (FIGS. 16 and 19), a substantially circular cartridge assembly (FIGS. 17A,17B and17C) and parallel jaw members (FIG. 18). It is further envisioned that different sub-classes of each class ofend effector1600 may be connectable toshaft portion1500.
• For instance, within the class ofend effectors1600 including a substantially circular cartridge assembly, gastrointestinal anastomosis-type devices, transverse anastomosis-type devices (see, e.g. U.S. Pat. Nos. 4,383,634, 5,782,396, 5,865,361 and 5,318,221 and circular anastomosis-type devices (see, e.g., U.S. Pat. No. 4,304,236). Gastrointestinal anastomosis-type devices are configured to drive and bend staples aligned in a row sequentially in rapid sequence, while transverse anastomosis-type devices drive and bend all staples simultaneously. Circular anastomosis-type devices are configured to simultaneously apply annular rows of staples to tissue.
• Additionally, within the class ofend effectors1600 having a pivotable cartridge assembly, sub-classes may includeend effectors1600 configured to drive staples sequentially andend effectors1600 configured to drive staples simultaneously.
• It is therefore envisioned that aparticular shaft portion1500 may be configured for use with a particular class ofend effectors1600, such asend effectors1600 including a substantially circular cartridge assembly. In such an embodiment, anothershaft portion1500 may be configured for use with another particular class ofend effectors1600, such asend effectors1600 including a pivotable cartridge assembly orend effectors1600 having jaw members that approximate with one another while remaining substantially paralle.
• It is further envisioned that aparticular shaft portion1500 may be configured for use with a particular type ofend effector1600, such asend effectors1600 configured for sequential firing of staples (includingend effectors1600 including a substantially circular cartridge assembly,end effectors1600 including a pivotable cartridge assembly orend effectors1600 having parallel approximating jaw members) orend effectors1600 configured for sequential firing of staples, for example.
• Additionally, it is envisioned that aparticular shaft portion1500 may be configured for use with several types ofend effectors1600, includingend effectors1600 including a substantially circular cartridge assembly, a pivotable cartridge assembly, parallel approximating jaw members, configured for sequential firing of staples and/or configured for simultaneous firing of staples. Here, a physician may select aparticular shaft portion1500 based on other characteristics, such asshaft portion1500 being articulatable, curved, or compliant, for example.
• At least one electronic component1700 may also be included on a portion ofsurgical instrument1000. It is envisioned that afirst sensor1700ais included onendoscopic portion1400, asecond sensor1700bis included onshaft portion1500, and athird sensor1700cis included onend effector1600. It is envisioned that sensors1700 cooperate with a receiver/controller in thehousing1100, elsewhere on theinstrument1000, or a device separate from theinstrument1000 for various purposes. For instance,first sensor1700amay be configured to detect the type ofshaft portion1500 that is engaged withendoscopic portion1400. Further,second sensor1700bmay be configured to detect the type ofend effector1600 that is engaged withshaft portion1500.
• It is further envisioned that auser interface1800 onhousing1100 is included. In a disclosed embodiment,user interface1800 includes a screen that displays at least some of the information (e.g., type ofshaft portion1500 connected toendoscopic portion1400, type ofend effector1600 connected toshaft portion1500, etc.) detected by sensors1700 insurgical instrument1000.User interface1800 may also display a condition ofend effector1600, such as angle of articulation or rotation, whether staples have been fired therefrom, if tissue is between jaw members, etc. This information may also be provided to a video screen or monitoring system in an operating room. For instance, the data may be transmitted to a receiver for the operating room monitoring system from a communication transmitter incorporated in or associated with poweredsurgical instrument1000, via technology including Blue Tooth, ANT3, KNX, Z Wave, X10, wireless USB, WiFi, IrDa, Nanonet, Tiny OS, ZigBee, radio, UHF and VHF.
• The present disclosure also relates to a method of applying surgical fasteners to tissue. The method includes the step of providing a poweredsurgical instrument100,1000, as described above. The method also includes connectingshaft portion1500 todistal end1402 ofendoscopic portion1400 and connectingend effector1600 todistal end1502 ofshaft portion1500.
• It will be understood that various modifications may be made to the embodiments disclosed herein. For example, the locations along the longitudinal axis fordrive motor210 and/or drivegear200 may be different than shown. Different types of gears for driving, rotation, articulation and/or actuation may be used. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

Claims (21)

1. A surgical instrument, comprising:

a housing;

an endoscopic portion extending distally from the housing and defining a first longitudinal axis;

a shaft portion selectively connectable to a distal end of the endoscopic portion; and

an end effector selectively connectable to a distal end of the shaft portion.

2. The surgical instrument ofclaim 1, further including a motor disposed in mechanical cooperation with the housing, the motor being configured to drive at least one function of the end effector.

3. The surgical instrument ofclaim 1, wherein the end effector defines a second longitudinal axis, the end effector being movable from a first position where the second longitudinal axis is substantially aligned with the first longitudinal axis to at least a second position where the second longitudinal axis is disposed at an angle to the first longitudinal axis.

4. The surgical instrument ofclaim 3, further comprising a motor disposed in mechanical cooperation with the housing, the motor being configured to cause the end effector to move from its first position towards its second position.

5. The surgical instrument ofclaim 1, wherein the end effector includes a cartridge assembly and an anvil assembly, the cartridge assembly and the anvil assembly being arranged for being approximated to engage tissue therebetween.

6. The surgical instrument ofclaim 1, further comprising a linkage rod arranged for translation substantially along the longitudinal axis and for engaging at least one of a portion of the shaft portion and the end effector.

7. The surgical instrument ofclaim 1, further comprising a user interface, the user interface including a screen that displays a condition of the end effector.

8. The surgical instrument ofclaim 1, wherein at least a portion of the shaft portion is flexible.

9. The surgical instrument ofclaim 1, wherein at least a portion of the shaft portion is curved.

10. The surgical instrument ofclaim 1, wherein at least a portion of the shaft portion is made from a compliant material.

11. The surgical instrument ofclaim 1, wherein the shaft portion is configured to accept a plurality of types of end effectors.

12. The surgical instrument ofclaim 11, wherein the plurality of types of end effectors includes end effectors having a pivotable cartridge assembly, a substantially circular cartridge assembly and parallel jaw members.

13. The surgical instrument ofclaim 11, further comprising at least one sensor disposed in communication with the end effector for helping to determine the type of end effector that is engaged with the shaft portion.

14. The surgical instrument ofclaim 1, wherein the endoscopic portion is configured to accept a plurality of types of shaft portions.

15. The surgical instrument ofclaim 14, further comprising at least one sensor disposed in communication with the shaft portion for helping to determine the type of shaft portion that is engaged with the endoscopic portion.

16. A surgical instrument, comprising:

a housing;

an endoscopic portion extending distally from the housing and defining a longitudinal axis;

a drive gear disposed at least partially within the housing, the drive gear rotatable about a drive gear axis extending therethrough and being selectively movable along the drive gear axis;

a drive motor disposed in mechanical cooperation with the drive gear and being configured to rotate the drive gear;

a shift motor disposed in mechanical cooperation with the drive gear and being configured to move the drive gear along the drive gear axis;

a shaft portion selectively connectable to a distal end of the endoscopic portion; and

an end effector selectively connectable to a distal end of the shaft portion.

17. The surgical instrument ofclaim 16, wherein at least a portion of the shaft portion is at least one of flexible and curved.

18. The surgical instrument ofclaim 16, wherein the shaft portion is configured to accept a plurality of types of end effectors.

19. A method of applying surgical fasteners to tissue, comprising the steps of:

providing a powered surgical instrument, including:

a housing;

an endoscopic portion extending distally from the housing and defining a longitudinal axis;

a shaft portion selectively connectable to a distal end of the endoscopic portion; and

an end effector selectively connectable to a distal end of the shaft portion;

connecting the shaft portion to the distal end of the endoscopic portion; and

connecting the end effector to the distal end of the shaft portion.

20. The method ofclaim 19, wherein the shaft portion is configured to accept a plurality of types of end effectors.

21-31. (canceled)

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