Surgical instrument for endoscopic and general surgery

A surgical instrument for use in endoscopy comprising:

• a tubular member with no joints and having a proximal end and a distal end;
• an end effector attached directly to the distal end of the tubular member at an attachment point, the end effector comprising a first pivotable working portion and a second pivotable working portion, the two working portions each extending from the attachment point and forming an operating angle therebetween;
• a handle releasably and rotatably attached to the proximal end of the tubular member, the handle comprising:
• an elongated grip portion having a longitudinal axis that extends at an angle relative to the longitudinal axis of the tubular member, wherein the grip portion is permanently fixed with respect to the longitudinal axis of the tubular member and grippable by a single hand;
• an actuating control;
• and
• a pivot control, the actuating and pivot controls being actuable by the same hand which grips the grip portion;
• and
• linkage extending through the tubular member, the linkage operably connecting the actuating control and the pivot control with the first and second end effector working portions, wherein:
• in response to the actuating control being actuated, the linkage acts on the end effector to alter the operating angle;
• and
• in response to the pivot control being actuated while the actuating control is not being actuated, the linkage acts on the end effector to pivot the working portions simultaneously in the same direction about the attachment point while maintaining a substantially constant operating angle.

A surgical instrument comprising:

• a handle with an elongated grip portion grippable by a single hand;
• a generally tubular barrel with no joints and having a first end and a second end, the first end being rotatably and releasably coupled to the handle, the grip portion of the handle having a longitudinal axis that extends at an angle relative to the longitudinal axis of the tubular member, wherein the grip portion is permanently fixed with respect to the longitudinal axis of the tubular barrel;
• a scissor-like working end effector tip having two pieces, each piece being pivotally connected directly to the second end of the barrel at a common attachment point and having a working portion extending generally distally from the attachment point and a lever portion extending generally proximally from the attachment point;
• elongated linkage members extending generally toward the handle, the linkage members including:
• a first linkage member attached to the first end effector piece and crossing around the lever portion of the first end effector piece to the lever portion of the second end effector piece and over a pulley on one side of the two end effector pieces;
• and
• a second linkage member attached to the second end effector piece and crossing around the lever portion of the second end effector piece to the lever portion of the first end effector piece and over a second pulley on the opposite side of the two end effector pieces;
• an actuating control carried by the handle and actuable by the same hand which grips the grip portion, wherein actuation of the actuating control translates both the first and the second linkage members simultaneously in the same direction to pivot the end effector working portions relative to one another;
• and
• a pivot control carried by the handle and actuable by the same hand which grips the grip portion, wherein actuation of the pivot control translates both the first and the second linkage members simultaneously in opposite directions to pivot the end effector working portions simultaneously in the same direction about the attachment point, and wherein, a substantially constant angle between the end effector working portions is maintained during the actuation of the pivot control if the actuating control is not also being actuated.

A surgical apparatus comprising:

• a tubular member having a distal end and a proximal end, an end effector movably attached to the distal end and a handle attached to the proximal end;
• means for rotating, pivoting and closing the end effector in any orientation relative to the tubular member including lengths of high-modulus tensile cords, a slidable, rotatable shaft with right- and left-handed threaded portions, said shaft being slidable and rotatable relative to the tubular member, two nuts operably received on the shaft and being slidable and non-rotating relative to the tubular member, and means for retracting the shaft in the proximal direction;
• and
• means for controlling said means for rotating, pivoting and closing.

A surgical instrument comprising:

• a handle;
• a generally tubular barrel having a first end and a second end, the first end being moveably and releasably coupled to the handle;
• a scissor-like working end effector tip pivotally coupled to the second end of the barrel and having two blades pivotally connected to the second end, each blade having a distal end and a proximal portion, the blades crossing over one another at a pivot point generally between the distal end and the proximal portion;
• elongated linkage members including a first linkage member attached to the first blade and crossing around the proximal portion of the first blade to the proximal portion of the second blade and over a pulley on one side of the two blades, and a second linkage member attached to the second blade and crossing around the proximal portion of the second blade to the proximal portion of the first blade and over a second pulley on the opposite side of the two blades, said linkage members extending generally toward the handle;
• a shaft received in the tubular barrel and being threaded in one direction adjacent to one end and in the opposite direction adjacent to the other end, two nuts received on the shaft, one of the nuts received on each threaded portion of the shaft, the nuts being constrained from rotating and slideable inside the barrel, one of said linkage members being connected to one nut, the second linkage member being connected to the second nut;
• and
• actuating means carried by the handle for operating the blades, said linkage members operably coupled to the actuating means.

A surgical apparatus comprising:

• a tubular member with no joints and having a distal end and a proximal end;
• an end effector attached directly to the distal end of the tubular member at an attachment point, the end effector comprising a first pivotable working portion and a second pivotable working portion, the two working portions each extending from the attachment point and forming an operating angle therebetween;
• a handle attached to the proximal end of the tubular member, the handle comprising:
• an elongated grip portion having a longitudinal axis that extends at an angle relative to the longitudinal axis of the tubular member, wherein the grip portion is permanently fixed with respect to the longitudinal axis of the tubular member and grippable by a single hand to maintain stability of the surgical apparatus during its operation;
• an actuating control;
• and
• a pivot control, the actuating and pivot controls being independent of one another and further being actuable by the same hand which grips the grip portion;
• and
• linkage extending through the tubular member, the linkage operably connecting the actuating control and the pivot control to the first and second end effector working portions, wherein:
• in response to the actuating control being actuated, the linkage acts on the end effector to alter the operating angle;
• and
• in response to the pivot control being actuated while the actuating control is not being actuated, the linkage acts on the end effector to pivot the end effector working portions about the attachment point simultaneously in the same direction while maintaining a substantially constant operating angle.