(19) United States
`(12) Patent Application Publication (10) Pub. No.: US 2007/0158385 A1
`
` Hueil et al. (43) Pub. Date: Jul. 12, 2007
`
`
`US 200701583 85Al
`
`(54) SURGICAL INSTRUMENT HAVING AN
`ARTICULATING END EFFECTOR
`
`Publication Classification
`
`(75)
`
`Inventors: Geoflrey c_ Hueil, Mason, OH (US);
`Joseph Charles Hueil, Loveland, OH
`(US); Kenneth Edward Hogue, Mason,
`OH (US); Christoph Lewis Gillum,
`Middletown OH (US) Douglas Jon
`Siebenaler ,Maineville OH (US)
`
`Correspondence Address:
`KIRKPATRICK & LOCKHART PRESTON
`
`GATES ELLIS LLP
`535 SMITHFIELD STREET
`PITTSBURGH, PA 15222 (US)
`
`(73) Assignee: Ethicon Endo-Surgery, Inc.
`
`(21) Appl. No.:
`
`11/329,020
`
`(22)
`
`Filed:
`
`Jan. 10, 2006
`
`(51)
`
`Int. Cl.
`(2006.01)
`A613 17/10
`(52) US. Cl.
`.......................................................... 227/1751
`
`ABSTRACT
`(57)
`An articulating surgical instrument is shown, which com-
`prises a shaft and an end effector. The shaft has a longitu-
`dinal axis, and the end effector is operationally coupled,
`preferably mechanically coupled, to the shaft at an articu-
`lation pivot. The instrument also comprises a first band, and
`in some embodiments, a second band, each operationally
`connected to the end effector and extending through at least
`a portion of the shaft. An articulation control applies a force
`in a direction substantially transverse to the longitudinal
`axis, wherein the force, when applied in one direction, is
`translated through the first band to the end effector to effect
`rotation of the end effector relative to the shaft about the
`articulation pivot in a first rotational direction, and when the
`force is applied in the opposite direction,
`is translated
`through the second band to the end effector to effect rotation
`of the end effector relative to the shaft about the articulation
`pivot in a second rotational direction.
`
` 1
`
`IS 1016
`
`IS 1016
`
`1
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 1 0f 19
`
`US 2007/0158385 A1
`
`
`
`2
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 2 0f 19
`
`US 2007/0158385 A1
`
`FIG.3
`
`3
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 3 0f 19
`
`US 2007/0158385 A1
`
`FIG.5
`
`4
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 4 0f 19
`
`US 2007/0158385 A1
`
`
`
`5
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 5 0f 19
`
`US 2007/0158385 A1
`
`.\\\\\\\\
`
`
`
`attititti.353.SEES...fiy/l3&3Vk\\\V\\\>.l25:55:55.5..
`
`‘\\\
`
`
`
`\\\\\\\\MIAl.\\\‘x.VIo\l
`
`
`
`
`
`
`
`
`
`
`7%~_“
`
`
`
`6
`
`
`
`
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 6 0f 19
`
`US 2007/0158385 A1
`
`121
`
`\
`
`134
`
`
`
`7
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 7 0f 19
`
`US 2007/0158385 A1
`
`98
`
`FIG.
`
`172
`
`i
`
`
`8
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 8 0f 19
`
`US 2007/0158385 A1
`
`11
`
`FIG.
`
`9
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 9 0f 19
`
`US 2007/0158385 A1
`
`“‘.‘~“.~.§
`
`
`
`II“il"“‘fl"““"“"‘."““"4I““"'.“"|“"“‘-."”1
`
`ll
`
`10
`
`10
`
`
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 10 0f 19
`
`US 2007/0158385 A1
`
`
`
`
`
`
`
`
`\.\\LI...-nflfi§fi~§§§HN55555:???\II
`
`
`
`11
`
`11
`
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 11 0f 19
`
`US 2007/0158385 A1
`
`121
`
`\ 1
`
`72
`
`12
`
`12
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 12 0f 19
`
`US 2007/0158385 A1
`
`,4-
`
` .‘2
`—;‘“——-—lll=i=
`‘
`
`
`
`r
`
`
`
`
`
`18
`
`
`FIG.
`
`17
`
`FIG.
`
`13
`
`13
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 13 0f 19
`
`US 2007/0158385 A1
`
`
`
`14
`
`i‘~§.‘~.‘~pfi.
`
`Q“,IIIII|
`
`
`lt’al“..l.|"““‘l“‘aII""‘|'II"III‘II|!
`
`fi\\\lil
`
`i.“.“|“‘lr“““‘l.““‘I“.“‘.“”""l
`
`NmN
`
`ON.o_.._
`
`14
`
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 14 0f 19
`
`US 2007/0158385 A1
`
`
`
`
`
` ~\““~‘l““-‘\‘méémlm\\\\.\\\\\\\\\
`
`
`
`
`
`
`
`\\N\\V\.\\r4\\\ V“‘x\A“‘~“\n“1.;a]\”I‘
`
`
`
`
`
`cow
`
`//¢O—
`
`“.“.‘.‘~‘.§
`
`
`
`'4,“"‘’“"‘““““‘.““""“‘4F“...I““"“““.““"’n
`
`Iii/Ila
`
`343i!
`
`.w.New
`
`
`
`"“"“““‘““"""““““""’I“I"‘I““‘."““"ll‘l
`
`mm.o_.._
`
`15
`
`15
`
`
`
`
`
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 15 0f 19
`
`US 2007/0158385 A1
`
`\\\\\‘\\“\§.‘
`
`
`
`3.,,.“523%
`
`
`V\\\\\\.‘\\N\Magi
`\\\\\\\\\\\V\
`
`.i“:------:-:-:-:~\
`
`VN.o_.._
`
`16
`
`16
`
`
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 16 0f 19
`
`US 2007/0158385 A1
`
`
`
`\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\N\\\\\\\\\.
`
`
`'g’
`
`
`
`
`
`In::\mm!\\\\\lrl1mmvhr.l,-IM,.wfllr1.’.l..'
`
`NNF
`
`
`I111!
`
`7'4lg.w////////
`
`
`
`
`
`
`
`
`
`
`
`17
`
`17
`
`
`
`
`
`
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 17 0f 19
`
`US 2007/0158385 A1
`
`
`
`18
`
`18
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 18 0f 19
`
`US 2007/0158385 A1
`
`538
`
`FIG. 28
`
`19
`
`19
`
`

`

`Patent Application Publication Jul. 12, 2007 Sheet 19 0f 19
`
`US 2007/0158385 A1
`
`
`
`
`
`
`
`20
`
`20
`
`

`

`US 2007/0158385 A1
`
`Jul. 12, 2007
`
`SURGICAL INSTRUMENT HAVING AN
`ARTICULATING END EFFECTOR
`
`FIELD OF THE INVENTION
`
`[0001] The present invention relates in general to surgical
`instruments, and more particularly to minimally invasive
`surgical instruments having an articulating end effector.
`
`BACKGROUND OF THE INVENTION
`
`[0002] Endoscopic and other minimally invasive surgical
`instruments typically include an end effector positioned at
`the distal end of an elongate shaft and a handle at the
`proximal end of the elongate shaft allowing a clinician to
`manipulate the end effector. In use,
`the end effector is
`provided to a surgical site through a cannula of a trocar. At
`the surgical site,
`the end effector engages tissue in any
`number of ways to achieve a diagnostic or therapeutic effect.
`Endoscopic surgical instruments are often preferred over
`traditional open surgical instruments because they require
`smaller incisions that generally heal with less post-operative
`recovery time than traditional open surgery incisions.
`Because of this and other benefits of endoscopic surgery,
`significant development has gone into a range of endoscopic
`surgical instruments having end effectors that engage tissue
`to accomplish a number of surgical tasks. For example, end
`effectors have been developed to act as endocutters, grasp-
`ers, cutters, staplers, clip appliers, access devices, drug/gene
`therapy delivery devices, ultrasound, RF, or laser energy
`devices, and other surgical instruments.
`
`[0003] FIGS. 1 & 2 show an exemplary prior art surgical
`and stapling instrument 10 including an end effector 12
`configured as an endocutter for clamping, severing and
`stapling tissue, for example, as disclosed in US. Application
`Publication No. 2004/0232196 Al, the disclosure of which
`is herein incorporated by reference in its entirety. The
`surgical stapling and severing instrument 10 includes a
`handle portion 20 connected to an implement portion 22, the
`latter further comprising a shaft 23 distally terminating in
`the end effector 12. The handle portion 20 includes a pistol
`grip 24 toward which a closure trigger 26 is pivotally drawn
`by the clinician to cause clamping, or closing, of the anvil 18
`toward the elongate channel 16 of the end effector 12. A
`firing trigger 28 is farther outboard of the closure trigger 26
`and is pivotally drawn by the clinician to cause the stapling
`and severing of clamped tissue in the end effector 12.
`
`[0004] Closure trigger 26 is actuated first. Once the clini-
`cian is satisfied with the positioning of the end effector 12,
`the clinician may draw back the closure trigger 26 to its fully
`closed, locked position proximate to the pistol grip 24. Then,
`the firing trigger 28 is actuated. The firing trigger 28
`springedly returns when the clinician removes pressure. A
`release button 30 when depressed on the proximal end of the
`handle portion 20 releases any locked closure trigger 26.
`
`[0005] A closure sleeve 32 encloses a frame 34, which in
`turn encloses a firing drive member 36 that is positioned by
`the firing trigger 28. The frame 34 connects the handle
`portion 20 to the end effector 12. With the closure sleeve 32
`withdrawn proximally by the closure trigger 26 as depicted,
`the anvil 18 opens, pivoting away from the elongate channel
`16 and translating proximally with the closure sleeve 32.
`The elongate channel 16 receives a staple cartridge 37.
`
`[0006] With particular reference to FIG. 2, the firing bar
`14 includes three vertically spaced pins that control the
`spacing of the end effector 12 during firing. In particular, an
`upper pin 38 is staged to enter an anvil pocket 40 near the
`pivot between the anvil 18 and elongate channel 16. When
`fired with the anvil 18 closed, the upper pin 38 advances
`distally within a longitudinal anvil slot 42 extending distally
`through anvil 18. Any minor upward deflection in the anvil
`18 is overcome by a downward force imparted by the upper
`pin 38.
`
`[0007] Firing bar 14 also includes a lower most pin, or
`firing bar cap, 44 that upwardly engages a channel slot 45 in
`the elongate channel 16, thereby cooperating with the upper
`pin 38 to draw the anvil 18 and the elongate channel 16
`slightly closer together in the event of excess tissue clamped
`therebetween.
`
`[0008] The firing bar 14 advantageously includes a middle
`pin 46 that passes through a firing drive slot 47 formed in a
`lower surface of the cartridge 37 and an upward surface of
`the elongate channel 16, thereby driving the staples therein
`as described below. The middle pin 46, by sliding against the
`lower surface of the cartridge 37, advantageously resists any
`tendency for the end effector 12 to be pinched shut at its
`distal end.
`
`[0009] A distally presented cutting edge 48 between the
`upper and middle pins 38, 46 on the firing bar 14 traverses
`through the cartridge 37 to sever clamped tissue. The
`affirmative positioning of the firing bar 14 with regard to the
`elongate channel 16 and anvil 18 assure that an effective cut
`is performed.
`
`[0010] The affirmative vertical spacing provided by the
`E-Beam firing bar 14 is suitable for the limited size available
`for endoscopic devices. Moreover, the E-Beam firing bar 14
`enables fabrication of an anvil 18 with a camber imparting
`a vertical deflection at its distal end. This cambered anvil 18
`advantageously assists in achieving the desired gap in the
`end effector 12 even with an anvil 18 of reduced thickness,
`which is thus more suited to the size limitations of an
`
`endoscopic device.
`
`[0011] The E-Beam firing bar 14 further enables increased
`applications, especially in combination with a range of
`configurations of staple cartridges. For instance, a clinician
`may select a gray staple cartridge yielding a 0.02 mm tissue
`gap, a white staple cartridge yielding a 0.04 mm tissue gap,
`a blue cartridge yielding a 0.06 mm tissue gap, or a green
`cartridge yielding a 0.10 mm tissue gap. The vertical height
`of each respective staple cartridge in combination with the
`length of staples and an integral wedge sled 50 predeter-
`mines this desired tissue thickness with the anvil 18 appro-
`priately vertically spaced by the E-Beam firing bar 14.
`
`[0012] With surgical instrument 10 as well as other mini-
`mally invasive instruments, the positioning of the end effec-
`tor at the surgical site is constrained by the trocar. Generally
`the elongate shaft 23 enables the clinician to insert the end
`effector to a desired depth and rotate the end effector about
`the longitudinal axis of the shaft. This allows the end effector
`to be positioned at
`the surgical site,
`to a degree. With
`judicious placement of the trocar and use of graspers, for
`instance, through another trocar, this amount of positioning
`is often sulficient. Depending upon the nature of the opera-
`tion, however, it may be desirable to adjust the positioning
`
`21
`
`21
`
`

`

`US 2007/0158385 A1
`
`Jul. 12, 2007
`
`of the end effector of an endoscopic surgical instrument. In
`particular, it is often desirable to orient the end effector at
`any one of multiple angles relative to the longitudinal axis
`of the elongate shaft of the instrument.
`
`[0013] Movement of the end effector through multiple
`angles relative to the instrument shaft
`is conventionally
`referred to as “articulation.” Articulation is typically accom-
`plished by a pivot (or articulation) joint being placed in the
`elongate shaft just proximal to the end effector. This allows
`the clinician to articulate the end effector remotely to either
`side for better surgical placement of the staple lines and
`easier tissue manipulation and orientation. An articulating
`end effector permits the clinician to more easily engage
`tissue in some instances, such as behind an organ.
`In
`addition, articulated positioning advantageously allows an
`endoscope to be positioned behind the end effector without
`being blocked by the elongate shaft.
`
`[0014] Approaches to articulating end effectors tend to be
`complicated because mechanisms for controlling the articu-
`lation must be integrated with mechanisms for operating the
`end effector. For example the closure sleeve, drive member
`and mechanisms for articulation must be implemented
`within the small diameter constraints of the instrument’s
`
`shaft. One common design involves an accordion-like
`articulation mechanism (“flex-neck”) that is articulated by
`selectively drawing back one of two connecting rods
`through the implement shaft, each rod offset respectively on
`opposite sides of the shaft centerline. The connecting rods
`ratchet through a series of discrete positions.
`
`[0015] While this generally-known approach successfully
`articulates the end effector about an articulation pivot, it is
`desirable to further enhance performance. Consequently, a
`significant need exists for an improved articulating surgical
`instrument.
`
`BRIEF SUMMARY OF THE INVENTION
`
`In accordance with one embodiment of the inven—
`[0016]
`tion, there is provided an articulating surgical instrument.
`The instrument in this embodiment comprises a shaft and an
`end effector. The shaft has a longitudinal axis, and the end
`effector is operationally coupled, preferably mechanically
`coupled, to the shaft at an articulation pivot. The instrument
`also comprises a first band operationally connected to the
`end effector and extending through at least a portion of the
`shaft. An articulation control applies a force in a direction
`substantially transverse to the longitudinal axis. The articu-
`lation control is operationally connected to the first band
`such that application of the force is translated through the
`first band to the end effector to effect rotation of the end
`effector relative to the shaft about the articulation pivot.
`
`In accordance with another embodiment having a
`[0017]
`shaft and end effector as described above, a second band is
`operationally connected to and extends from the end effector
`through at least a portion of the shaft. In this embodiment,
`the articulation control is also configured to apply the force
`in a second direction substantially transverse to the longi-
`tudinal axis. The force is translated through the second band
`to the end effector to effect rotation of the end effector
`
`relative to the shaft about the articulation pivot in a second
`rotational direction.
`
`[0018] The articulation control in one embodiment may be
`structured for movement in a first direction for applying the
`
`force in a first transverse direction to effect rotation of the
`end effector in a first rotational direction relative to the shaft.
`
`In this embodiment, the articulation control may also be
`structured for movement in a second direction for applying
`the force in a second transverse direction, opposite to the
`first transverse direction, to effect rotation of the end effector
`in a second rotational direction relative to the shaft.
`
`[0019] The articulation control may include an articulation
`slide that is movable transversely across the shaft to first,
`second and neutral positions. The articulation slide defines a
`slot positioned at about
`the longitudinal axis when the
`articulation slide is in the neutral position and the first and
`second bands pass through the slot. The articulation slot is
`offset from the longitudinal axis when the articulation slide
`is in either one of the first or the second positions.
`
`the first band and the
`In various embodiments,
`[0020]
`second band are pre-bent toward the longitudinal axis when
`the articulation control is in a neutral position, when no force
`is applied to the articulation control. In yet another embodi-
`ment having a shaft and end effector, the first band has a first
`end mechanically coupled to the end effector at a point offset
`from the articulation axis.
`
`In accordance with another embodiment having a
`[0021]
`shaft and end effector as described above, the instrument has
`a first hydraulic articulation bladder expandable toward the
`first band. A hydraulic actuation bladder
`is
`fluidically
`coupled to the first hydraulic articulation bladder. Also, in
`various embodiments, a first actuation button is positioned
`to compress the first hydraulic actuation bladder. Compres-
`sion of the first hydraulic actuation bladder causes the first
`hydraulic articulation bladder to inflate. Expansion of the
`first hydraulic articulation bladder toward the first band
`causes bending of the first band which effects rotation of the
`end effector relative to the shaft about the articulation pivot
`in a first rotational direction. In another embodiment of the
`
`instrument, a second hydraulic articulation bladder may be
`provided. Expansion of the second hydraulic articulation
`bladder toward the second band causes bending of the
`second band which effects rotation of the end effector
`
`relative to the shaft about the articulation pivot in a second
`rotational direction.
`
`In accordance with another embodiment of the
`[0022]
`invention,
`there is provided a method for operating the
`instrument. The method may comprise the step of applying
`a force to the instrument in a direction that is substantially
`transverse to the shaft, wherein the force causes the first
`band to bend, and wherein the bending of the first band
`causes the end effector to pivot relative to the shaft about the
`articulation pivot in a first direction.
`BRIEF DESCRIPTION OF THE FIGURES
`
`[0023] The accompanying drawings, which are incorpo-
`rated in and constitute part of the specification, illustrate
`embodiments of the invention and, together with the general
`description of the invention given above, and the detailed
`description of the embodiments given below, serve to
`explain the principles of the present invention.
`
`[0024] FIG. 1 depicts a partially cut-away side elevation
`view of a prior art surgical instrument;
`
`[0025] FIG. 2 depicts a cross-sectional side elevation
`detail view along the line 2-2 of FIG. 1 of an end elfector of
`the prior art surgical instrument;
`
`22
`
`22
`
`

`

`US 2007/0158385 A1
`
`Jul. 12, 2007
`
`[0026] FIG. 3 depicts a three dimensional view of a
`surgical instrument according to various embodiments of the
`present invention;
`
`[0044] FIG. 20 depicts a top-down cross-sectional view of
`an articulation control of the surgical instrument of FIG. 19
`in a neutral position;
`
`[0027] FIG. 4 depicts side view of a surgical instrument
`according to various embodiments of the present invention;
`
`[0028] FIG. 5 depicts a top down view of a surgical
`instrument according to various embodiments of the present
`invention;
`
`[0029] FIG. 6 depicts a top down cross-sectional view of
`an end effector and elongate, shaft of a surgical instrument
`according to one embodiment of the present invention;
`
`[0030] FIG. 7 depicts a top down cross-section view of an
`articulation pivot of the surgical instrument of FIG. 6 in a
`neutral position;
`
`[0031] FIG. 8 depicts a top down cross-section view of an
`articulation control of the surgical instrument of FIG. 6 in a
`neutral position;
`
`[0032] FIG. 9A depicts an exploded view of an end
`effector and elongate shaft of a surgical instrument having an
`articulation pivot like that of the instrument of FIG. 6;
`
`[0033] FIG. 9B depicts a top down view of the firing bar
`of the instrument of FIG. 9;
`
`[0034] FIG. 10 depicts a side cross-section view of an
`articulation pivot of the surgical instrument of FIG. 6;
`
`[0035] FIG. 11 depicts a three dimensional view of an end
`effector and articulation pivot of the surgical instrument of
`FIG. 10;
`
`[0036] FIG. 12 depicts an end effector, articulation pivot,
`and articulation control of the surgical instrument of FIG. 6
`with the end effector articulated to the left according to
`various embodiments of the present invention;
`
`[0037] FIG. 13 depicts a top down cross-section view of
`an articulation control of the surgical instrument of FIG. 6
`pushed to the left to move the end effector as shown in FIG.
`12;
`
`[0038] FIG. 14 depicts a top down cross-section view of
`an articulation pivot of a surgical instrument according to
`another embodiment of the present invention;
`
`[0039] FIG. 15 depicts an exploded view of an end elfector
`and elongate shaft of a surgical instrument having an articu-
`lation pivot like that of the instrument of FIG. 14;
`
`[0040] FIG. 16 depicts a side cross-section view of
`another embodiment of the articulation pivot of a surgical
`instrument having the articulation pivot of FIG. 14;
`
`[0041] FIG. 17 depicts the end effector, articulation pivot,
`and articulation control of the surgical instrument of FIGS.
`14-16 with the end effector in a neutral position;
`
`[0042] FIG. 18 depicts the end effector, articulation pivot,
`and articulation control of the surgical instrument of FIGS.
`14-16 with the end effector articulated to the left;
`
`[0043] FIG. 19 depicts a top-down cross-sectional view of
`a surgical instrument according to one embodiment of the
`present invention;
`
`[0045] FIG. 21 depicts a top-down cross-sectional view of
`the shaft, cables, and spring assemblies of the surgical
`instrument of FIG. 19 in a neutral position;
`
`[0046] FIG. 22 depicts a top-down cross-sectional view of
`an articulation control of the surgical instrument of FIG. 19
`articulated to the left;
`
`[0047] FIG. 23 depicts a top-down cross-sectional view of
`the surgical instrument of FIG. 19 articulated to the left;
`
`[0048] FIG. 24 depicts a top-down cross-sectional view of
`the shaft, cables, and spring assemblies of the surgical
`instrument of FIG. 19 articulated to the left;
`
`[0049] FIG. 25 depicts a top down cross-section view of
`an articulation pivot of a surgical instrument according to
`another embodiment of the present invention;
`
`[0050] FIG. 26 depicts a side cross-section view of the
`articulation pivot of the surgical instrument of FIG. 25;
`
`[0051] FIG. 27 depicts an exploded view of an end effector
`and elongate shaft of a surgical instrument having an articu-
`lation pivot like that of the instrument of FIGS. 25 and 26;
`
`[0052] FIG. 28 depicts a hydraulically actuated articula-
`tion control of a surgical instrument useful to the embodi-
`ment of the present invention shown in FIGS. 25 and 26;
`
`[0053] FIG. 29 depicts an end effector and articulation
`pivot of the surgical instrument of FIGS. 25-27 with the end
`effector in a neutral position; and
`
`[0054] FIG. 30 depicts the end effector and articulation
`pivot of the surgical instrument of FIGS. 25-27 with the end
`effector articulated to the right.
`
`DETAILED DESCRIPTION OF THE
`INVENTION
`
`[0055] FIGS. 3-5 show an exemplary surgical instrument
`100 generally including a handle 103, a shaft 104 and an
`articulating end effector 102 pivotally connected to the shaft
`104 at articulation pivot 110. An articulation control 112 is
`provided to effect rotation of the end effector 102 about
`articulation pivot 110. The end effector 102 is shown c011-
`figured to act as an endocutter for clamping, severing and
`stapling tissue, however, it will be appreciated that various
`embodiments of the present
`invention may include end
`effectors (not shown) configured to act as other surgical
`devices including, for example, graspers, cutters, staplers,
`clip appliers, access devices, drug/gene therapy delivery
`devices, ultrasound, RF, or laser energy devices, etc.
`
`[0056] The handle 103 of the instrument 100 may include
`closure trigger 114 and firing trigger 116 for actuating the
`end efiector 102. It will be appreciated that instruments
`having end effectors directed to different surgical tasks may
`have different numbers or types of triggers or other suitable
`controls for operating an end effector. The end effector 102
`is shown separated from a handle 103 by the preferably
`elongate shaft 104. A clinician may articulate the end
`elfector 102 relative to the shaft 104 by utilizing the articu-
`lation control 112.
`
`23
`
`23
`
`

`

`US 2007/0158385 A1
`
`Jul. 12, 2007
`
`It should be appreciated that spatial terms such as
`[0057]
`vertical, horizontal, right, left etc., are given herein with
`reference to the figures assuming that the longitudinal axis
`of the surgical instrument 100 is co-axial to the central axis
`of the shaft 104, with the triggers 114, 116 extending
`downwardly at an acute angle from the bottom of the handle
`103. In actual practice, however, the surgical instrument 100
`may be oriented at various angles and as such these spatial
`terms are used relative to the surgical instrument 100 itself.
`Further, proximal
`is used to denote a perspective of a
`clinician who is behind the handle 103 who places the end
`effector 102 distal, or away from him or herself.
`
`the term “fluidically coupled”
`[0058] As used herein,
`means that
`the elements are coupled together with an
`appropriate line or other means to permit the passage of
`pressurized fluid medium, air, etc. therebetween. As used
`herein, the term “line” as used in “supply line,”“hydraulic
`line” or “return line” refers to an appropriate fluid passage
`formed from conduit, pipe,
`tubing, etc. for transporting
`pressurized hydraulic fluid from one component to another.
`
`[0059] As used herein, the term, “hydraulic fluid” refers to
`any fluid suitable for use in a hydraulic system. Non-limiting
`examples of hydraulic fluids include oil, air, etc. In one
`non-limiting embodiment, hydraulic fluids may be biocom-
`patable fluids including, for example, glycerin oil, saline,
`etc.
`
`[0060] As used herein, the phrase, “substantially trans-
`verse to the longitudinal axis” where the “longitudinal axis”
`is the axis of the shaft, refers to a direction that is nearly
`perpendicular to the longitudinal axis. It will be appreciated,
`however, that directions that deviate some from perpendicu-
`lar to the longitudinal axis are also substantially transverse
`to the longitudinal axis.
`
`[0061] Various embodiments of the present invention are
`directed to instruments having an articulation pivot driven
`by bending cables or bands. FIG. 6 shows a cross-sectional
`top down view of an exemplary elongate shaft 104 and end
`effector 102 including a bending band driven articulation
`pivot 110. In the non-limiting embodiment of FIG. 6, band
`205 is mechanically coupled to boss 206 located at the
`articulation pivot 110. The band 205 may include band
`portions 202 and 204 extending proximally from the boss
`206 along the elongate shaft 104 and through the articulation
`control 112. The band 205 and band portions 202, 204 are
`preferably of a fixed length
`
`[0062] FIG. 7 shows a cross-sectional view of the articu-
`lation pivot 110 shown in FIG. 6 including the boss 206 and
`band 205. The band 205 may be mechanically coupled to the
`boss 206 as shown using any suitable fastening method
`including,
`for example, glue, welding, etc.
`In various
`embodiments, each band portion 202, 204 may be provided
`as a separate band, with each separate band having one end
`mechanically coupled to the boss 206 and another end
`extending through the shaft 104 and articulation controller
`112 (not shown in FIG. 7). The separate bands may be
`mechanically coupled to the boss 206 as described above.
`
`[0063] Band portions 202, 204 may extend from the boss
`206, through the articulation pivot 110 and along the shaft
`104 to the articulation control 112, shown in FIG. 8. The
`articulation control 112 may include an articulation slide
`208, a frame 212 and an enclosure 218. Band portions 202,
`
`204 may pass through the articulation slide 208 by way of
`slot 210 or other aperture, although it will be appreciated
`that the band portions 202, 204 may be coupled to the slide
`208 by any suitable means. The articulation slide 208 may
`be one piece, as shown in FIG. 8, or may in one non-limiting
`embodiment, include two pieces with an interface between
`the two pieces defining the slot 210. In one non-limiting
`embodiment, the articulation slide 208 may include multiple
`slots, for example, with each slot corresponding to one of
`band portions 202, 204. Enclosure 218 may cover the
`various components of the control 112 to prevent debris
`from entering.
`
`In various embodiments, band portions 202, 204
`[0064]
`may be anchored to the frame 212 at connection points 214,
`216 proximally located from the slot 210. The non-limiting
`embodiment of FIG. 8 shows that the band portions 202, 204
`are pre-bent from connection points 214, 216 to the slot 210,
`located near the longitudinal axis of the shaft 104. It will be
`appreciated that band portions 202, 204 may be anchored
`anywhere in the instrument 10 located proximally from the
`slot 210, including the handle 103.
`
`[0065] FIGS. 9A-11 show views of the end effector 102
`and elongate shaft 104 of the instrument 100 including the
`articulation pivot 110 shown in FIG. 7. The end effector 102
`shown in FIGS. 9A—11 is configured to act as an endocutter.
`It will be appreciated that in various embodiments, the end
`effector 102 may be configured to perform other surgical
`tasks, requiring the removal, modification, or addition of
`components from what is shown in the figures. Also, it will
`be appreciated that the end effectors 102 shown in FIGS.
`3-6, 11 may be customized for specific surgical applications.
`For example, FIGS. 3-6 and 10-12 show a 45 mm endocutter
`end effector while FIG. 9A shows a 60 mm endocutter end
`effector.
`
`[0066] FIG. 9A shows an exploded view of the end
`effector 102 and elongate shaft 104 including various inter-
`nal components. An end eflector frame 150 and shaft frame
`154 are configured to be joined at articulation pivot 110.
`Boss 206 may be integral to the end effector frame 150 with
`band 205 interfacing the boss 206 as shown. The shaft frame
`154 may include a distally directed tang 302 defining an
`aperture 304. The aperture 304 may be positioned to inter-
`face an articulation pin (not shown) included in end effector
`frame 150 allowing the end effector frame 150 to pivot
`relative to the shaft frame 154, and accordingly, the end
`effector 102 to pivot relative to the shaft 104. When
`assembled, the various components may pivot about articu-
`lation pivot 110 at an articulation axis 306 shown in FIGS.
`10 and 11.
`
`[0067] FIG. 9A also shows an anvil 120. In this non-
`limiting embodiment, the anvil 120 is coupled to the elon-
`gate channel 198. For example, apertures 199 of the elongate
`channel 198 may receive pins 152 of the anvil 120, allowing
`the anvil 120 to pivot from an open position to a closed
`position relative to the elongate channel 198 and staple
`cartridge 118. A spring clip 158 is mounted in the end
`effector frame 150 as a lockout for firing bar 172. Distal and
`proximal square apertures 164, 168 formed on top of the end
`effector frame 150 may define a clip bar 170 therebetween
`that receives a top arm 162 of a clip spring 158 whose lower,
`distally extended arm 160 asserts a downward force on a
`raised portion 174 of the firing bar 172 discussed below. It
`
`24
`
`24
`
`

`

`US 2007/0158385 A1
`
`Jul. 12, 2007
`
`will be appreciated that various embodiments may include
`other types of lockouts or no lockouts at all.
`
`In addition, FIG. 9A shows the firing bar 172,
`[0068]
`configured to longitudinally translate through the shaft
`frame 154, through the flexible closure and pivoting frame
`articulation joint 110, and through a firing slot 176 in the
`distal frame ground 150 into the end effector 102. The firing
`bar 172 may be constructed from one solid section, or in
`various embodiments, may include a laminate material
`comprising, for example, a stack of steel plates 173 as shown
`in FIG. 9B. It will be appreciated that a firing bar 172 made
`from a laminate material may lower the force required to
`articulate the end effector 102. A distally projecting end of
`the firing bar 172 is attached to an E-beam 178 that assists
`in spacing the anvil 120 from the staple cartridge 118 when
`the anvil 120 is in a closed position. Sharpened cutting edge
`182 of the E-beam 178 may also be used to sever tissue.
`
`In operation, the E-beam 178 actuates the staple
`[0069]
`cartridge 118. The staple cartridge 118 includes a molded
`cartridge body 194 that holds a plurality of staples 191
`resting upon staple drivers 192 within respective upwardly
`open staple apertures 195. A wedge sled 190 is driven
`distally by the E-beam 178, sliding upon a cartridge tray 196
`that holds together the various components of the replace-
`able staple cartridge 118. The wed