United States Patent
`
`[191
`
`Slater et al.
`
`1111
`
`[45]
`
`Patent Number:
`
`5,396,900
`
`Date of Patent:
`
`Mar. 14, 1995
`
`US005396900A
`
`[541
`
`ENDOSCOPIC END EFFECTORS
`CONSTRUCI‘ED FROM A COMBINATION
`OF CONDUCTIVE AND NON-CONDUCTIVE
`MATERIALS AND USEFUL FOR SELECTIVE
`ENDOSCOPIC CAUTERY
`
`Inventors:
`
`Assignee:
`Appl. No.:
`Filed:
`
`Charles R. Slater, Fort Lauderdale;
`Matthew A. Palmer, Miami; Peter
`Kratsch, Sunrise, all of Fla.
`
`Symbiosis Corporation, Miami, Fla.
`
`107,454
`
`Aug. 17, 1993
`
`Related U.S. Application Data
`Continuation-in—part of Ser. No. 922,023, Jul. 28, 1992,
`Pat. No. 5,331,971, which is a continuation of Ser. No.
`680,392, Apr. 4, 1991, Pat. No. 5,192,298, and a con-
`tinuation-in-part of Ser. No. 978,249, Nov. 18, 1992,
`Pat. No.
`
`Int. Cl.‘ ............................................ .. A61B 17/36
`U.S. Cl. ..................................... .. 128/751; 606/46
`Field of Search ................ .. 128/749, 751; 606/29,
`606/41, 44-52, 205, 207, 211
`References Cited
`
`U.S. PATENT DOCUMENTS
`
`1,071,978 9/1913 White .................................... 606/43
`3,100,489
`8/1963 Bagley.
`.
`3,460,539
`8/1969 Anhalt, Sr.
`3,920,021 11/1975 Hiltebrandt.
`3,987,795 10/1976 Morrison .
`4,074,718 2/1978 Morrison, Jr.
`4,232,676 11/1980 Herczog .
`4,418,692 12/1983 Guay .
`4,622,966 11/ 1986 Beard .
`4,681,105 7/1987 Tritt .........................
`4,685,459
`8/1987 Koch et al.
`..
`4,763,669 8/ 1988 Jaeger ..................
`4,802,476 2/1989 Noerenberg et al.
`
`.
`
`.
`
`Rydell ........ ..
`
`4/1991
`.................. 606/47
`5,007,908
`...... 606/43
`9/1991
`5,049,148
`.. 606/S0 X
`2/1992
`5,085,659
`.... .. 606/51
`5,151,102 9/1992
`5,217,458
`6/1993 Parins ............................. .. 606/50 X
`
`FOREIGN PATENT DOCUMENTS
`5172441 12/1992 European Pat. Off.
`A61B 17/39
`5182301 12/1992 European Pat. Off.
`A61B 17/39
`
`Primary Examiner—Lee S. Cohen
`Assistant Examiner——Samuel Gilbert
`Attorney, Agent. or Fz'rm—David P. Gordon
`[57]
`ABSTRACI‘
`A non-metallic end effector for use in an endoscopic
`surgical tool includes a metallic core for strength and
`for providing a selected electrode surface on the end
`effector. Selectively conductive end effectors are manu-
`factured by insert molding a plastic or ceramic or other
`non-conductive body around a metallic or otherwise
`conductive core. The conductive core is exposed on a
`selected portion of the working surface of the end effec-
`tor and extends through the non-conductive body of the
`end effector for coupling to an electrical source. Selec-
`tively conductive end effectors of this type can also be
`manufactured by coating 21 cast end effector member
`with a non-conductive polymer or by metallically plat-
`ing a non-conductive ceramic end effector member. By
`extending the conductive core of a selectively conduc-
`tive end effector member to the pivot hole of the mem-
`ber, electrical coupling can be made through the clevis
`and tube of an endoscopic instrument, By extending the
`conductive core to the actuation bore of an end effector
`member, electrical coupling can be made through the
`push rod or other actuation member in an endoscopic
`instrument. Using both techniques, a bipolar selective
`cautery end effector can be provided on an endoscopic
`instrument.
`
`25 Claims, 6 Drawing Sheets
`
`ETHICON ENDO-SURGERY, INC.
`
`EX. 1011
`
`1
`
`

`
`U.S. Patent
`
`4w1NM
`
`5991
`
`Sheet 1 of 6
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`2
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`

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`U.S. Patent
`
`Mar. 14, 1995
`
`Sheet 2 of 6
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`5,396,900
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`3
`
`

`
`U.S. Patent
`
`Mar. 14, 1995
`
`Sheet 3 of 6
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`5,396,900
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`4
`
`

`
`Sheet 4 of 6
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`5,396,900
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`5
`
`

`
`U.S. Patent
`
`59914:1LaM
`
`Sheet 5 of 6
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`5,396,900
`
`IurI-.llIn\l_l_|Pl|.laI.:Inll.nI:|..1.
`
`
`In.IHh.|.dns.vN$.I.l|sIP...uNh..nIIIIIIII.
`
`6
`
`

`
`U.S. Patent
`
`Mar. 14, 1995
`
`Sheet 6 of 6
`
`5,396,900
`
`1090
`
`I008
`
`FIG.
`
`I00
`
`FIG.
`
`|Ob
`
`7
`
`

`
`1
`
`5,396,900
`
`ENDOSCOPIC END EFFECIORS CONSTRUCFED
`FROM A COMBINATION OF CONDUCTIVE AND
`NON-CONDUCFIVE MATERIALS AND USEFUL
`FOR SELECTIVE ENDOSCOPIC CAUTERY
`
`This application is a continuation-in-part of Ser. Nos.
`07/922,023, filed Jul. 28, 1992 (which is a continuation of
`Ser. No. 07/680,392, filed Apr. 4, 1991, now issued as
`U.S. Pat. #5,192,298), 07/978,249 filed Nov. 18, 1992,
`entitled “Arthroscopic Surgical
`Instruments”, and
`O8/016,595, filed Feb. 11, 1993 entitled “Endoscopic
`Biopsy Forceps Devices with Selective Bipolar Cau-
`tery” now abandoned, which are hereby incorporated
`by reference herein in their entireties.
`BACKGROUND OF THE INVENTION
`
`This invention relates to endoscopic surgical devices.
`More particularly, the invention relates to an endo-
`scopic surgical tool having end effectors made out of a
`combination of plastic or ceramic and metal and useful
`for selective endoscopic cautery.
`Endoscopic surgery is widely practiced throughout
`the world today and its acceptance is growing rapidly.
`In general, endoscopic surgery involves one or more
`incisions made by trocars where trocar tubes are left in
`place so that endoscopic surgical tools may be inserted
`through the tubes. A camera, magnifying lens, or other
`optical instrument is often inserted through one trocar
`tube, while a cutter, dissector, or other surgical instru-
`ment is inserted through the same or another trocar tube
`for purposes of manipulating and/or cutting the internal
`organ. Sometimes it is desirable to have several trocar
`tubes in place at once in order to receive several surgi-
`cal instruments. In this manner, organ or tissue may be
`grasped with one surgical
`instrument, and simulta-
`neously may be cut with another surgical instrument; all
`under view of the surgeon via the optical instrument in
`place in the trocar tube.
`Various types of endoscopic surgical instruments are
`known in the art. These instruments generally comprise
`a slender tube containing a push rod which is axially
`movable within the tube by means of a handle or trig-
`ger-like actuating means. An end effector is provided at
`the distal end of the tube and is coupled to the push rod
`by means of a clevis so that axial movement of the push
`rod is translatedto rotational or pivotal movement of
`the end effector. End effectors may take the form of
`scissors, grippers, cutting jaws, forceps, and the like.
`Because of their very small size and the requirements of
`strength and/or sharpness, end effectors are difficult to
`manufacture and are typically formed of forged stain-
`less steel. As such, they form an expensive portion of
`the endoscopic instrument.
`Modern endoscopic procedures often involve the use
`of electrocautery. Indeed, several types of electrocau-
`tery devices for use in endoscopic surgery are described
`in the prior art. U.S. Pat. No. 4,418,692 to Guay, for
`example, discloses a device for use in laparoscopic tubal
`cauterization for blocking the Fallopian tubes of a pa-
`tient. The device comprises a substantially tubular body
`member having a spring-biased piston slidably mounted
`therein. A pair of electrodes (either monopolar or bipo-
`lar) are disposed to grasp living tissue when the piston is
`in a first position biased by the spring and to release the
`tissue when a button is pressed which moves the piston
`into a second position. The device includes a circuit
`breaker which interrupts current flowing to the elec-
`
`10
`
`15
`
`20
`
`25
`
`30
`
`45
`
`50
`
`55
`
`2
`trodes when the piston is in the second position. When
`the electrodes grasp the tissue, however, current is
`supplied to the entire surface of the electrode, that is,
`both the grasping surface and the outer non-grasping
`surface.
`Another electrosurgical instrument for use in combi-
`nation with an endoscope is disclosed in U.S. Pat. No.
`5,007,908 to Rydell for “Electrosurgical Instrument
`Having Needle Cutting Electrode and Spot-Coag Elec-
`trode”. Rydel1’s device includes an elongated flexible
`tubular member with a plurality of lumens. The distal
`end of the tubular member is provided with a bullet
`shaped ceramic tip covered with a conductive layer and
`having an opening coupled to a first one of the lumens.
`The conductive layer is coupled to a conductor which
`extends through a second one of the lumens to an elec-
`trical source. A second conductor, also coupled to the
`electrical source is slidable through the first lumen by a
`plunger. The two electrodes form a bipolar pair. In a
`second embodiment, the conductive layer on the ce-
`ramic tip is split by an insulating gap and both halves of
`the tip form a bipolar pair of electrodes. As with the
`Guay device, above, substantially the entire distal sur-
`face of Rydel1’s device serves as an electrode when
`energized.
`Other electrocautery probes for use with an endo-
`scope are disclosed in U.S. Pat. No. 3,920,021 to Hilte-
`brandt. Hiltebrandt discloses several types of probes
`similar to Rydel1’s in that they have a substantially bul-
`let shaped tip with hemispheric or annular conductors
`forming electrode pairs. Hiltebrandt also shows elec-
`trodes similar to Guay’s; a pair of springy arms slidable
`through a tube member to grasp and release tissue. Of
`course, the gripping force obtainable by either Guay’s
`or Hiltebrandt probes is severely limited because the
`electrodes must be “springy”.
`It is known in electrosurgery to insulate a portion of
`the surface area of an electrode so that only a precise or
`at least well defined portion of an elect:rode’s surface is
`conductive. This is desirable in order to protect both
`the surgeon and the tissue adjacent to the site of electro-
`surgery from accidental cautery by an electrode having
`a broad fully conductive surface. U.S. Pat. No.
`3,100,489 to Bagley, for example, shows cautery forceps
`where the entire surface of the forceps with the excep-
`tion of the forceps tips is provided with an overall pli-
`able insulating coating of rubber or synthetic rubber-
`like material. U.S. Pat. No. 5,049,148 to Mehl discloses
`a “Radio Frequency Hair Removal Tweezer” which
`includes insulated tweezer arms with conducting pads
`at the tips of the arms so that RF energy can be applied
`to individual hairs without burning surrounding skin
`through arcing. Nevertheless, it is heretofore unknown
`to selectively insulate portions of an endoscopic end
`effector to provide a well defined and discrete electro-
`surgical surface. It is also heretofore unknown to make
`endoscopic end effectors primarily from plastic, as plas-
`tic is typically considered too weak to properly serve
`desired functions.
`
`SUMMARY OF THE INVENTION
`
`It is therefore an object of the invention to provide an
`. endoscopic surgical instrument with a cauterizing end
`effector where only a part of the surface of the end
`effector is electrically conductive.
`It is also an object of the invention to provide a sub-
`stantially non-conductive end effector with an electri-
`cally conductive reinforcing core or skeleton.
`
`8
`
`

`
`3
`It is another object of the invention to provide meth-
`ods of manufacturing selectively conductive end effec-
`tors.
`
`It is a further object of the invention to provide
`means for electrically coupling a selected conductive
`surface of an end effector to an electrical source.
`It is yet another object of the invention to provide
`means for electrically coupling selected conductive
`surfaces of two end effector members to an electrical
`source for bipolar cautery.
`It is still another object of the invention to provide a
`non-metallic end effector having a strength enhancing
`metal spine.
`In accord with these objects which will be discussed
`in detail below, the present invention includes an endo-
`scopic surgical instrument having a tube with a push
`rod or wire axially movable therein and coupled at its
`proximal end to an actuator. An end effector is coupled
`to the push rod or wire at the distal end of the tube
`through a clevis so that axial movement of the push rod
`is translated to ‘rotational or pivotal movement of the
`end effector. The end effector is formed of both con-
`ductive material and non-conductive material; the non-
`conductive material surrounding all of the conductive
`material but for a selected electrode surface and a se-
`lected surface for coupling with an electrical source.
`Preferred aspects of the invention include insert
`molding a conductive metal in a non-conductive ce-
`ramic or plastic end effector. Alternatively, the end
`effector may be formed by injection molding a non-con-
`ductive end effector and plating conductive surfaces
`onto it. Another preferred method of forming the end
`effector is by casting a conductive end effector and
`coating it with an insulating polymer or other insulating
`material. Preferred conductive surfaces include a single
`conductive point electrode rising from or flush with the
`surface of an otherwise non-conductive end effector or
`a linear electrode surface on an otherwise non-conduc-
`tive end effector. Alternatively, the conductive surface
`may be a plurality of defined conductive electrode sur-
`faces on an otherwise non-conductive end effector. It is
`also preferred that means be provided for electrically
`coupling the conductive surface of the end effector to
`an electrical source through the tube and/or the push
`rod of the endoscopic instrument. When both the tube
`and the push rod are separately coupled to different
`poles of an electrical source, as with a bipolar arrange-
`ment, means for electrically insulating the push rod,
`clevis, tube and end effectors from each other are also
`provided.
`In accord with other aspects of the invention, differ-
`ent end effectors for endoscopic instruments are pro-
`vided which use metal cores or spines as reinforcement
`for plastic, or which use metal cutting edges as part of 55_
`a plastic end effector. The end effectors are not neces-
`sarily used in conjunction with a cautery application.
`Additional objects and advantages of the invention
`will become apparent to those skilled in the art upon
`reference to the detailed description taken in conjunc-
`tion with the provided figures.
`BRIEF DESCRIPTION OF THE DRAWING
`
`45
`
`FIG. 1 is a side elevation in partial cross section of the
`proximal end of an endoscopic instrument with an elec-
`trical connection to the tube;
`FIG. 1a is an enlarged detail of the tube of the instru-
`ment of FIG. 1;
`
`5,396,900
`
`4
`FIG. 1b is a side elevation View of the distal end of
`the instrument of FIG. 1;
`FIG. 2 is a side elevation schematic view of the distal
`end of an endoscopic instrument with single action
`selective cautery end effector;
`FIG. 2a is a bottom plan view of the selective cautery
`end effector of FIG. 2;
`FIG. 2b is a perspective view of the end effector of
`FIG. 2a;
`FIG. 3 is a top plan view of an embodiment of a
`double action selective cautery end effector;
`FIG. 3a is a side elevation view of the end effector of
`FIG. 3;
`FIG. 3b is a perspective view of a conductive core or
`skeleton used to insert mold the end effector of FIG. 3;
`FIG. 4 is a view similar to FIG. 3b but of another
`embodiment of selective cautery end effector;
`FIG. 4a is a perspective view of a conductive core or
`skeleton used to insert mold the end effector of FIG. 4;
`FIG. 5 is a top plan view of yet another embodiment
`of selective cautery end effector;
`FIG. 5a is a perspective view of a conductive core or
`skeleton used to insert mold the end effector of FIG. 5;
`FIG. 6 is a side elevation view of a biopsy forceps jaw
`end effector having a conductive skeleton insert molded
`in a non-conductive body;
`FIG. 6a is a side elevation view of the conductive
`skeleton of the end effector of FIG. 6;
`FIG. 6b is a top plan view of the skeleton of FIG. 6;
`FIG. 7 is a side elevation view of a biopsy forceps jaw
`end effector of injection molded plastic whose teeth are
`rendered conductive by an external conductive trace;
`FIG. 8 is a side elevation view of a biopsy forceps jaw
`end effector cast in metal and selectively coated with an
`insulating polymer;
`FIGS. 9a and 9b are side elevation views in partial
`cross section of an endoscopic tool with bipolar selec-
`tive cautery end effectors;
`FIG. 10a is a transparent side elevation view of an
`insert molded arthroscopic end effector with a conduc-
`tive razor blade insert; and
`FIG. 10b is a transparent perspective view of the
`arthroscopic end effector of FIG. 10a.
`DETAILED DESCRIPTION OF THE
`PREFERRED EMBODIMENTS
`
`An endoscopic surgical instrument is shown in FIGS.
`1, la and lb and generally includes a metal (e.g., alumi-
`num) tube 15 surrounded by a peripheral insulating
`shrink wrap layer of plastic 20, a clevis 30, end effectors
`40, actuating means 50, and a push rod 60. The clevis 30
`is usually a separately formed aluminum piece which
`fixedly engages aluminum tube 15 and also engages the
`end effectors 40 which pivotally engage clevis 30 at
`pivot pin 45. End effectors 40 generally includes two
`members 90, 92 at least one of which is pivotally en-
`gaged to clevis 30. When both members are pivotally
`engaged, the instrument is said to be “double acting”
`whereas when only one of the members 90, 92 is pivot-
`ally engaged, the instrument is said to be “single act-
`ing”. The push rod 60, which is also usually formed of
`aluminum or stainless steel, is engaged at its distal end
`65 to the end effector 40 and is connected its proximal
`end 70 to a manually operable actuating means 50. In
`use,
`the endoscopic instrument is inserted with the
`members 90, 92 of the end effector 40 in the closed
`position 129, through a troear tube into a body incision.
`The members 90, 92 can be opened and closed, as indi-
`
`9
`
`

`
`5
`cated by arrows 127, by reciprocal motion, as indicated
`by arrows 62, of push rod 60 which results from opera-
`tion, as indicated by arrows 52, of the manual actuating
`means 50.
`The endoscopic instrument shown in FIG. 1 includes
`an electrical connector 115 which couples an electrical
`source to the tube 15 and thus to the clevis 30 and the
`end effector 40 for monopolar cautery.
`Referring now to FIG. 2, an end effector 290 accord-
`ing to the invention is shown mounted on a clevis 30 by
`a clevis pin 45 at the distal end of an endoscopic instru-
`ment such as the one shown in FIG. 1. The end effector
`shown in FIG. 2 is a “single acting” end effector since
`movement of push rod 60 effects rotation of end effec-
`tor member 290 about clevis pin 45 while a stationary
`member 292 is fixedly coupled to the clevis 30 or tube
`15.
`Turning to FIGS. 2a and 2b with reference to FIG. 2,
`end effector 290 generally includes a distal portion 212
`and a proximal portion 210 with a pivot bore 206 there-
`between. The end effector is mounted on the clevis 30
`by a clevis pin 45 which passes through the pivot bore
`206 of the end effector 290 and engages the clevis 30.
`The proximal portion 210 of the end effector 290 in-
`cludes a second “actuation” bore 208 which receives
`either a link 67 which couples the end effector to the
`push rod 60 or the push rod itself so that axial move-
`ment of the push rod 60 through the tube 15 causes
`rotation of the end effector about the clevis pin 45. The
`distal portion 212 of the end effector generally includes
`a working surface 202 which in this embodiment is a
`gripping surface. In accord with the invention, the end
`effector 290 is constructed of non—conductive material
`such as molded plastic or non-conductive ceramic. In
`order to provide a selected conductive surface within
`the working surface 202 and to strengthen the end effec-
`tor 290, a metal spine 204 is insert molded in the non-
`conductive material of which the end effector is made.
`In this embodiment, the conductive spine 204 occupies
`part of the distal portion 212 of the end effector, extend-
`ing along a relatively thin surface 205 within the work-
`ing surface 202 of the end effector, penetrating within
`the body of the end effector to a portion 216 which is
`totally insulated by the non-conductive body of the end
`effector and emerging at 214 to communicate with the
`pivot bore 206. As will be appreciated by those skilled
`in the art, the selected narrow conductive surface 205 of
`end effector 290 is electrically coupled to the tube 15
`via the conductive clevis pin 45 which extends through
`the pivot bore 206, and via the conductive clevis 30
`which couples the tube and the pin. When an electrical
`source is coupled to the tube 15 as shown in prior art
`FIG. 1, end effector 290 becomes an electrocautery
`electrode with a very well defined conductive surface
`205. During electrocautery operations, surrounding
`tissues are protected from the conductive surface 205 by
`the otherwise non-conductive body of the end effector
`290. In order to insulate the conductive clevis 30 from
`surrounding tissues, the plastic layer 20 covering tube
`15 is preferably extended to cover the clevis 30 as
`shown in FIG. 2.
`The method of insert molding a conductive spine or
`skeleton in a non-conductive end effector can be used to
`produce a variety of single acting or double acting
`instruments. FIGS. 3 through 6b show but a few em-
`bodiments of the invention using this method of insert
`molding. FIGS. 3, 3a and 3b show a gripper end effec-
`tor 390 with a very small conductive spot electrode 305
`
`45
`
`5,396,900
`
`6
`formed on its working surface 302 by an insert molded
`conductive spine 304. As with the embodiment of FIG.
`2, this spine 304 extends into the body of the end effec-
`tor to create an electrical coupling at 314 through the
`pivot bore 306 of the end effector 390. Thus, the spot
`electrode 305 formed on the working surface 302 of the
`end effector 390 receives its electrical connection
`through the clevis and tube as described above.
`FIGS. 4 and 4a show another embodiment of end
`effector 490 having a pointed electrode 405 rising from
`the working surface 402. In this embodiment, inserted
`spine 404 extends into the body of the end effector to a
`portion 414 for an electrical coupling through actuation
`bore'408 of the end effector. With end effector 490, an
`electrical source is coupled to the push rod of an endo-
`scopic instrument as described in detail below with
`reference to FIGS. 9a and 9b. It should be noted that in
`this embodiment, the pivot bore 406 is non-conductive
`and insulated from the spine 404 by the non-conductive
`body of the end effector 490. Similarly, in the end effec-
`tors 290, 390 described above, the actuation bores 208,
`308 are non-conductive and insulated from the pivot
`bores 206, 306 by the non-conductive body of the end
`effector. As described in detail below with reference to
`FIGS. 91: and 9b, using one end effector member with
`an electrode surface coupled to the pivot bore and an-
`other end effector member with an electrode surface
`coupled to the actuation bore makes endoscopic bipolar
`selective cautery possible.
`The inserted conductive spine may be more than just
`a single element “spine” or “core”. FIGS. 5 and 50
`show an embodiment of end effector 590 having three
`surface point electrodes 505, 506, 507 on its working
`surface 502. These three electrodes are formed by in-
`serting a fork-like skeleton 504 in the mold for the end
`effector 590. The fork-like skeleton 504 has three tines
`which extend from the surface points through the body
`of the otherwise non-conductive end effector to a collar
`514 which may be aligned with either the pivot bore or
`the actuator bore of the end effector. It will be appreci-
`ated by those skilled in the art that the metal tines not
`only serve to provide a selective cautery function, but
`also act to strengthen the overall structure of the end
`effector.
`FIGS. 6, 6a, and 6b show a more elaborate skeleton
`604 used to construct a biopsy forceps jaw end effector
`690 with conductive teeth 605. In this embodiment,
`conductive skeleton insert 604 is formed by casting,
`stamping, or by photochemical milling or machining
`and is preferably provided with a number of fixation
`(staking) holes 620. The skeleton is used as an insert for
`an insert-type injection mold which is filled with plastic.
`While the skeleton 604 is inserted in the mold, the non-
`conductive plastic or ceramic material flows through
`these staking holes 620 to anchor the skeleton and
`strengthen the end effector. The proximal end 614 of
`the skeleton may enter the pivot bore 606 or the actua-
`tor bore 608 as shown. Moreover, the skeleton may exit
`the end effector shell at the proximal end as indicated by
`dotted line 609 whereby the actuator bore 608 in the
`proximal end 614 of the skeleton is available for an
`electrically conductive coupling with a push rod.
`In addition to insert molding, a selectively conduc-
`tive end effector can be formed by injection molding
`with subsequent selective plating. FIG. 7 shows an
`injection molded ceramic (e.g. alumina, zirconia, etc.)
`biopsy forceps jaw 790 with plated traces 714, 704, 705
`for electrical conductivity in the teeth and at the proxi-
`
`10
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`

`
`5,396,900
`
`7
`mal connection 708 to a push rod or other actuator. The
`plated traces are provided on the ceramic surface or in
`the ceramic and may be applied by sputtering or by
`other suitable procedures.
`Besides molding, cast end effectors can be made se-
`lectively conductive by coating. FIG. 8 shows a cast
`biopsy forceps jaw 890 coated with a very thin highly
`insulating polymer 891 such as PARYLENE manufac-
`tured by Union Carbide. The teeth 80S and proximal
`connection 814 are uncoated and thus conductive.
`These conductive portions can be masked before coat-
`ing the jaw or can be ground or polished to remove
`portions of the coating after the jaw is coated. The
`PARYLENE is preferably deposited evenly on the jaw
`surfaces by applying it in a tumbling or other process in
`a vacuum at room temperature with the teeth 805 and
`proximal connection 814 masked before coating. It will
`also be appreciated that removal of the polymer from
`the proximal connection can be effected by drilling hole
`808 after coating to provide an uninsulated surface
`within hole 808.
`As mentioned above, any of the embodiments of the
`selectively conductive end effectors can be made to
`electrically couple with either the clevis pin or the push
`rod, and a double acting bipolar selective cautery end
`effector can be constructed by making one of the end
`effector elements electrically couple with the tube and
`the other couple with the push rod (provided the tube
`and push rod are electrically isolated from each other).
`FIGS. 9a and 9b show a bipolar selective cautery endo-
`scopic instrument where one pole is coupled through
`the tube 15 and the other through the push rod 60. As
`mentioned above, with reference to FIG. 1, it is known
`to couple an electrical source to the tube 15 as with
`connector 115 shown in both FIG. 1 and FIG. 9a. FIG.
`9a also shows, however, an electrical connection
`through connector 160 which couples with the proxi-
`mal end 70 of the push rod 60. With both of these con-
`nections, it is possible to provide bipolar cautery at the
`distal end of the instrument shown in FIG. 9b.
`FIG. 9b shows a conductive clevis 30 with a conduc-
`tive clevis pin 45 electrically coupling the pivot bore
`906 of an end effector member 90. End effector member
`90 is constructed in a manner similar to the end effector
`390 shown in FIG. 3a insofar as the selected conductive
`portion on the working surface of the end effector is
`electrically coupled with the pivot bore while the rest
`of the end effector is non-conductive. In this manner,
`the electrical pole coupled to connector 115 in FIG. 9a
`is coupled through the tube 15, the clevis 30, and the
`clevis pin 45 to the selected conductive portion of end
`effector 90 via the pivot bore 906. FIG. 9b also shows
`push rod 60 electrically insulated from clevis 30 by a
`non-conductive lining 23 on the interior surface of
`clevis 30. Push rod 60 is coupled to the actuation bores 55
`908, 909 of end effector members 90 and 92 by conduc-
`tive links 67. End effector member 92 is constructed in
`a manner similar to the end effector 490 in FIG. 4 inso-
`far as the selected conductive portion on the working
`surface of the end effector is electrically coupled with 60
`the actuation bore while the rest of the end effector is
`non-conductive. In this manner, the electrical pole cou-
`pled to connector 160 in FIG. 9a is coupled through the
`push rod 60 and the conductive links 67 to the selected
`conductive portion of end effector member 92 via the
`actuation bore 909. Because both end effectors are non-
`conductive but for their selected conductive surface
`and proximal connection to either the pivot bore or the
`
`8
`actuation bore as described above, the conductive link
`67 makes no electrical coupling to end effector member
`90 and the conductive clevis 30 and clevis pin 45 make
`no electrical coupling to end effector member 92.
`FIGS. 10a and 10b show a surgical punch end effec-
`tor having a stationary jaw 1090 and a movable jaw
`1092. The stationary jaw has a shank portion 1030
`which fits lockingly inside tube 15 and which is pro-
`vided with a throughbore 1022 for receiving a push rod
`60. The movable jaw is pivotally attached to the station-
`ary jaw by mating surfaces 1012, 1014 and is linked to
`the distal end of the push rod 60 by a pin 1008. The
`stationary jaw 1090 is provided with an opening 1020
`into which the movable jaw 1092 pivots. In this way the
`stationary jaw functions as a die and the movable jaw as
`a punch for cutting through tissue. In accord with the
`invention, the end effector of FIGS. 10a and 10b is
`constructed of injection molded plastic or ceramic with
`a preformed and ground razor blade 1005 insert molded
`into the opening 1020 of the stationary jaw 1090. The
`movable jaw 1092 is provided with an overlapping rim
`1093 which covers the blade 1005 when the jaws are
`closed. The razor blade 1005 is typically conductive,
`while the remainder of the end effector is non-conduc-
`tive. If desired, the conductive blade 1005 can be elec-
`trically coupled to the tube 15 in any of the ways dis-
`cussed above.
`There have been described and illustrated herein
`several embodiments of a selectively conductive end
`effector member and means for electrically coupling
`end effector members to an electrical source. While
`particular embodiments of the invention have been
`described, it is not intended that the invention be limited
`thereto, as it is intended that the invention be as broad in
`scope as the art will allow and that the specification be
`read likewise. Thus, while particular types of end effec-
`tors, namely grippers, and arthroscopic and biopsy
`jaws, have been disclosed, it will be appreciated that
`other types of end effectors can embody the invention.
`It is possible, therefore to use the methods and materials
`disclosed herein to create other types of end effectors
`such as cutters, dissectors, scissors, and the like. Also,
`while specific clevis, push rod and actuation means
`have been shown, it will be recognized that the selec-
`tive cautery end effectors of the invention could be used
`with other kinds of endoscopic instruments having
`somewhat different clevis and actuation mechanisms.
`Thus, while the selective cautery end effector members
`have been disclosed as having pivot bores and actuation
`bores, it will be appreciated that other arrangements
`can be utilized. Likewise, it will be understood that
`stationary end effector members without pivot or actua-
`tion bores can be constructed according to the inven-
`tion, for example for use in bipolar single action end
`effectors.
`It will further be appreciated by those skilled in the
`art that while particular conductive and non-conduc-
`tive materials have been disclosed, other materials
`could be used as well. In addition, while non-conduc-
`tive end effector members with conductive cores have
`been shown for the purpose of selective cautery, it will
`also be recognized that a metallic core in a non-metallic
`end effector member strengthens the member and al-
`lows the construction of less expensive non-metallic end
`effectors which may be useful without cautery. It will
`therefore be appreciated by those skilled in the art that
`yet other modifications could be made to the provided
`
`11
`
`

`
`5,396,900
`
`10
`9
`10. An end effector member according to claim 9,
`invention without deviating from its spirit and scope as
`wherein:
`S0 claimed.
`said non-conductive body includes a pivot bore be-
`We claim:
`tween said proximal end and said distal end, and
`1. An end effector member for an endoscopic surgical
`said conductive portion compfises a metallic spine
`instrument l'1ZlVll'lg 3. ClCVlS and an actuation means, said
`extending from a point on said surface portion into
`end effect“ member Compfisingi
`said non-conductive body and to said pivot bore.
`3) 3 H011-metallic b0dY i13Ving 3 Pmximai end; 8 distal
`11. An end effector member according to claim 10,
`end, 3-ndfi Wofking surface;
`wherein;
`b) a metallic core extending within the non-metallic
`said conductive portion extends from said point on
`50d)’ and Substantially enclosed by said n0n'm5i3l‘
`Said surface portion out from said body_
`he body, said metallic core strengthening said non-
`12. An end effector member according to claim 10,
`metallic body;
`.
`_
`_
`wherein,
`c) means for coupling one of said non-metalli