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1. US6582451 - Device for use in surgery

Note: Text based on automatic Optical Character Recognition processes. Please use the PDF version for legal matters

[ EN ]

What is claimed is:

1. A device for manipulating tissues of a body of a patient or animal, the device including:
a support means;
a reciprocating member which moves relative to the support means;
an articulated jaw structure having:
a first and at least a second jaw member, each jaw member having a proximal end and a constraining surface adjacent its proximal end; and
an articulating means for articulating the jaw members in response to reciprocation of the reciprocating member, the articulating means including:
first and second connecting members, and at least first and second articulation members, wherein the first and second connecting members are each connected by a first pivotal connection to the reciprocating member and extend to respective second and third pivotal connections, and the first and second articulation members are connected together intermediate their respective ends by a fourth pivotal connection mounted to the support means, the first articulation member extending from said second pivotal connection to a fifth pivotal connection with the second jaw member distal its proximal end, and the second articulation member extending from said third pivotal connection to a sixth pivotal connection with the first jaw member distal its proximal end, the second pivotal connection being adapted to engage the constraining surface of the first jaw member and the third pivotal connection being adapted to engage the constraining surface of the second jaw member, such that on relative movement of the reciprocating member towards or away from the fourth pivotal connection, the second and third pivotal connections are also caused to move relatively away from or towards one another, so moving the jaw members relatively away from or towards one another.
 
2. The device of claim 1 wherein reciprocation of the reciprocating member results in relative movement of the jaw members in parallel relation to one another throughout the range of motion of the jaw members.
 
3. The device of claim 2 wherein on reciprocation of the reciprocating member both jaw members each move an equal distance away from or towards each other depending on the direction of movement of the reciprocating member.
 
4. The device of claim 2 wherein on reciprocation of the reciprocating member one jaw member remains stationary while the other jaw member moves relative to it.
 
5. The device of claim 4 wherein said stationary jaw member is connected to or an integral part of the support means.
 
6. The device of claim 1 wherein opposed faces of the respective jaw members are planar.
 
7. The device of claim 6 wherein the opposed faces remain parallel throughout the range of motion of the jaw members.
 
8. The device of claim 1 wherein the opposed faces of the respective jaw members maintain an angular relationship with respect to one another, irrespective of the relative position of the jaw members to one another, on reciprocation of the reciprocating member.
 
9. The device of claim 1 wherein the relative orientation of the jaw members to each other is adjustable.
 
10. The device of claim 1 wherein the jaw members are moved relatively apart when the reciprocating member is pushed relatively forward in a direction toward the distal end of the device and moved relatively closer together when the reciprocating member is pulled relatively backward in a direction toward the proximal end of the device.
 
11. The device of claim 1 wherein the support means comprises a cylinder with a lumen having a proximal end and a distal end, the articulation means and jaw members being at least partially disposed in the lumen.
 
12. The device of claim 11 wherein the articulation means is secured to the support means by a pin passing through said fourth pivotal connection of the first and second articulation members.
 
13. The device of claim 12 wherein the fourth pivotal connection between the first and second articulation members is proximate the distal end of the support means.
 
14. The device of claim 11 wherein the cross-sectional diameter of the support means varies along its length.
 
15. The device of claim 14 wherein the cross-sectional diameter of the support means tapers from a larger cross-sectional diameter at a region adjacent its proximal end to a smaller cross-sectional diameter at a region adjacent its distal end.
 
16. The device of claim 11 wherein the support means extends distally from its connection with the articulating means, this extension of the support means acting as a tissue guard to prevent tissue entering the region between the jaw members and being damaged by the articulation members on movement of the jaw members.
 
17. The device of claim 1 wherein each constraining surface is located adjacent the proximal end of its respective jaw member.
 
18. The device of claim 17 wherein each constraining surface constitutes a slot which, when the device is viewed in side elevation, has a longitudinal axis and two ends.
 
19. The device of claim 18 wherein the slot is substantially rectangular to provide for longitudinal movement of the pivotal connection between the connection member and articulation member engaged in that slot.
 
20. The device of claim 1 wherein the constraining surface of each jaw member is identical in shape, such that the movement of each of the pivotal connections between the two sets of corresponding connection member and articulation member corresponds with the other.
 
21. The device of claim 1 wherein said second and third pivotal connections slidably engage their respective constraining surfaces.
 
22. The device of claim 1 wherein the articulating means is located lateral to the jaw members, with a first pin extending from the second pivotal connection between the first connecting member and the first articulation member to engage the constraining surface of the first jaw member, a second pin extending from the third pivotal connection between the second connecting member and the second articulation member to engage the constraining surface of the second jaw member, a third pin constituting the fifth pivotal connection and extending between the first articulating member to a position on the second jaw member distal its proximal end, and a fourth pin constitute the sixth pivotal connection and extending between the second articulating member to a position on the first jaw member distal its proximal end.
 
23. The device of claim 22 wherein an articulating means is positioned on each side of the jaw members.
 
24. The device of claim 1 wherein an outer surface of each jaw member has a radius of curvature to minimise tissue trauma.
 
25. The device of claim 6 wherein the opposed surfaces of the jaw members have a radius of curvature to minimise tissue trauma.
 
26. The device of claim 24 wherein the curved surface constitutes a portion of a spherical surface, an oblate spherical surface, a cylindrical surface, or a parabolic surface.
 
27. The device of claim 6 wherein, when the device is to be used for grasping or clamping tissues, at least a portion of the opposed surfaces of each jaw member are lined with a plurality of gripping members.
 
28. The device of claim 6 wherein at least one of the jaw members has a chamber, an opening in the chamber at the proximal end and a plurality of orifices on the opposed surface of the jaw member such that the space between the jaw members, the chamber and the opening at the proximal end of the jaw member are in fluid communication with one another.
 
29. The device of claim 28 wherein the device can include a suction means adapted to apply suction to the chamber opening and so the chamber and the plurality of orifices, such that tissue manipulated by the device is held to the opposed face while ever suction is applied to the opening.
 
30. The device of claim 28 wherein a pipe extends from the chamber opening to the suction means.
 
31. The device of claim 29 wherein the suction means is adjustable to control the amount of suction applied to the tissue manipulated by the device.
 
32. The device of claim 28 wherein a fluid can be passed through the chamber and the plurality of orifices of the opposed face.
 
33. The device of claim 32 wherein the fluid is an irrigating fluid.
 
34. The device of claim 1 wherein the device is mountable to a delivery means for delivery into a patient's body through an access port.
 
35. The device of claim 34 wherein the device is releasably mounted to the delivery means such that it can be released and left in situ to provide ongoing mechanical retraction or support.
 
36. The device of claim 1 wherein a lumen extends through the device from its proximal end to its distal end.
 
37. The device of claim 36 wherein instruments that can be passed through the lumen are selected from the group comprising a camera, diagnostic probes, suction and irrigation means, biopsy forceps, biopsy needles or any other delivery means of diagnostic or therapeutic modalities.
 
38. The device of claim 1 when used for manipulating, grasping, cutting, cauterising, clipping, spreading, retracting, stapling or clamping tissues during open or minimally invasive surgical procedures.
 
39. The device of claim 36 wherein an outer surface of each of the jaw members are used to separate vertebral bodies during minimal access spinal surgery.
 
40. The device of claim 39 wherein the jaw members are adapted to give mechanical support to the spinal column or body structure, as a cage, or other vertebral support means, is deployed through the lumen of the instrument into the space provided by the retracted jaw members.
 
41. The device of claim 1 wherein the jaw members act as platforms for diagnostic or therapeutic modalities selected from the group comprising ultrasound, lithotripsy, radiotherapy, radiofrequency, unipolar and dipolar electrocautery, stapler-cutters and/or for the application of clips.
 
42. The device of claim 1 wherein the device includes a calibrated measuring scale, a cutting blade mounted to one jaw member and a receptacle on the other jaw member adapted to receive the cutting blade on closure of the jaw members, the measuring scale allowing a user to determine the dimensions of the cut being made to tissue grasped by the jaw members.
 
43. The device of claim 1 wherein an ultrasonic emitter is incorporated into the first jaw member, and an ultrasonic receiver is incorporated into the second jaw member.
 
44. The device of claim 1 wherein a pulse-echo ultrasound transducer/receiver is incorporated into the first jaw member, while the second jaw member is used to secure tissue between the jaw members.
 
45. The device of claim 1 wherein a compliant extension member having a longitudinal axis, and a distal end extends from each of the distal ends of the jaw members.