Title of Invention

A SURGICAL INSTRUMENT.

Abstract The invention relates to a surgical instrument (10), comprising an end effector (12); a shaft (23) having a longitudinal axis and having an articulation motion transfer member operatively configured to transfer an articulation motion; an articulation mechanism (11) responsive to the articulation motion from the articulation motion transfer member and pivotally coupling the end effector (12) to a distal end of the shaft (23) in a single plane bisected by the longitudinal axis to articulate selectively in a first direction and a second direction; and an articulation control (13) coupled to a proximal portion of the shaft (23), comprising: an actuator (202) laterally and linearly positionable by a user, a lateral motion therefrom aligned to the single plane to correspond to the selected one of the first and second direction of articulation, and a motion conversion mechanism (240) coupled to the actuator (202) and to the articulation mechanism (11) and operably configured to convert the lateral motion from the articulation control (13) to an articulation motion.
Full Text FIELD OF THE INVENTION
The present invention relates in general to surgical instruments that are suitable
for endoscopically inserting an end effector (e.g., endocutter, grasper, cutter,
staplers, clip applier, access device, drug/gene therapy delivery device, and a
energy device using ultrasound, RF, laser, etc.) to a surgical site, and more
particularly to such surgical instruments with an articulating shaft.
BACKGROUND OF THE INVENTION
Endoscopic surgical instruments are often preferred over traditional open
surgical devices since a smaller incision tends to reduce the post-operative
recovery time and complications. Consequently, significant development has
gone into a range of endoscopic surgical instruments that are suitable for precise
placement of a distal end effector at a desired surgical site through a cannula of
a trocar. These distal end effectors engage the tissue in a number of ways to
achieve a diagnostic or therapeutic

effect (e.g., endocutter, grasper, cutter, staplers, clip applier, access device, drug/gene
therapy delivery device, and energy device using ultrasound, RF, laser, etc.).
Positioning the end effector is constrained by the trocar. Generally these endoscopic
surgical instruments include a long shaft between the end effector and a handle portion
manipulated by the clinician, this long shaft enables insertion to a desired depth and
rotation about the longitudinal axis of the shaft, thereby positioning the end effector to a
degree. With judicious placement of the trocar and use of graspers, for instance, through
another trocar, often this amount of positioning is sufficient. Surgical stapling and
severing instruments, such as described in U.S. Pat. No. 5,465,895, are an example of
an endoscopic surgical instrument that successfully positions an end effector by
insertion and rotation.
Depending upon the nature of the operation, it may be desirable to further adjust the
positioning of the end effector of an endoscopic surgical instrument rather than being
limited to insertion and rotation. In particular, it is often desirable to orient the end
effector at an axis transverse to the longitudinal axis of the shaft of the instrument. The
transverse movement of the end effector relative to the instrument shaft is conventionally
referred to as "articulation". This articulated positioning permits the clinician to more
easily engage tissue in some instances. In addition, articulated positioning
advantageously allows an endoscope to be positioned behind the end effector without
being blocked by the instrument shaft.
While the aforementioned non-articulating stapling and severing instruments have great
utility and may be successfully employed in many surgical procedures, it is desirable to
enhance their operation with the ability to articulate the end effector, thereby giving
greater clinical flexibility in their use. To that end, the four above cross-referenced
applications disclose use of a rotational motion to articulate an end effector of a surgical

stapling and severing instrument. A clinician rotates an outer control at the base
of the shaft of the instrument to effect this articulation. In other articulating
surgical instruments, articulation is generally effected by a longitudinal or
rotational control input that is transferred as a longitudinal movement to the
articulation joint. For instance, U.S. Pat. No. 6,241,139 describes a rotary control
operably coupled to a stepped cam driver slot. Rotary motion of the control
moves an

intermediate piece containing the stepped cam driver slot laterally to articulate
the end effector.
While these articulation controls do perform the intended function, it is believed
that an enhanced articulation control may provide additional benefits. For
instance, it would be desirable if the visual indication and tactile feel provided by
the articulation control were intuitively understood by the clinician as to the
expected direction and amount of articulation In addition, it would be further
desirable that the articulation control readily accept adjustment by the clinician
yet resist a force on the end effector that may inadvertently change the amount of
articulation. Furthermore, it would be further desirable that some versions of the
articulation control be particularly suited for a surgical stapling and severing
instrument that has a rotational motion down the shaft to effect articulation.
Consequently, a significant need exists for an improved articulation control for a
surgical instrument.
SUMMARY OF THE INVENTION
The invention overcomes the above-noted and other deficiencies of the prior art
by providing an articulating surgical instrument that advantageously incorporates
a lateral articulation control so that the user has an intuitive control of the
articulation of an end effector. Such an instrument has particular utility in
endoscopic use wherein the end effector is passed through a cannula
passageway to a surgical site. Reaching the surgical site at a desired orientation,
and perhaps being inserted behind other tissue, is facilitated by an articulation of

the end effector from the longitudinal axis of a shaft. This task is assisted by the
lateral articulation control providing an intuitive indication of the direction and
amount of articulation of the end effector.
In one aspect of the invention, a surgical instrument that positions an end effector
at a surgical site for performing a diagnostic or therapeutic treatment by inserting
its shaft through a cannula passageway. The shaft advantageously includes an
articulation motion transfer member that allows a clinician to articulate the end
effector from a longitudinal axis of the shaft by controlling an articulation
mechanism that pivotally couples the end effector to a distal end of the shaft. The
user laterally

positions an actuator to cause this articulation motion to be transferred through
the shaft, with the lateral motion thereof converted into the articulation motion by
a motion conversion mechanism. Thereby, the user receives an intuitive
indication of which direction the end effector is articulated and the relative
amount of articulation.
In another aspect of the invention, a surgical instrument performs articulation of
the end effector by an articulation mechanism that responds to a rotational
motion. A lateral articulation control again provides the intuitive control to a user
by converting lateral motion into the rotational motion transferred through the
shaft to the articulation mechanism.
In yet another aspect of the invention, a surgical instrument that is suitable
endoscopic for such operations as stapling and severing by having three motions
transferable to an end effector, specifically a firing motion, a closing motion, and
an articulation motion. The lateral articulation control is positionable by the user
to produce the articulation motion that causes the end effector to articulate. Since
the end effector is remotely viewed by an endoscope that may be oriented from a
different perspective than the user of the instrument, which may complicate
visualizing the amount and direction of articulation of the of the end effector.
However, the lateral articulation control proximate to a handle of the device gives
the user this feed back.
These and other objects and advantages of the present invention shall be made
apparent from the accompanying drawings and the description thereof.

BRIEF DESCRIPTION OF THE ACCOMPANYING DRAWINGS
The accompanying drawings, which are incorporated in and constitute a part of
this 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.
FIG. 1 is a perspective view of an articulating surgical instrument in a
nonarticulated position.
FIG. 2 is a perspective view of an articulating surgical instrument in an
articulated position.

FIG. 3 is a perspective view of an opened end effector of the articulating surgical
instrument of FIGS. 1-2.
FIG. 4 depicts a side elevation view in section of the end effector of FIG. 3 of the
surgical instrument of FIG. 1, the section generally taken along lines 4-4 of FIG. 3
to expose portions of a staple cartridge but also depicting the firing bar along the
longitudinal centerline.
FIG. 5 depicts a side elevation view in section of the end effector of FIG. 4 after
the firing bar has fully fired.
FIG. 6 depicts a side elevation view in section of a handle portion of a proximal
end of the surgical instrument of FIG. 1 including a rotating articulation control.
FIG. 7 depicts a perspective, exploded view of the handle portion of the proximal
end of the surgical instrument of FIG. 1.
FIG. 8 depicts a perspective view looking downward, forward and to the right of a
distal portion of the handle portion of the surgical instrument of FIG. 1 partially
cutaway to expose a rotating articulation control mechanism.
FIG. 9 depicts a perspective view looking upward, rearward and to the right of the
distal portion of the handle portion of FIG. 8, partially cutaway to expose the
rotating articulation control mechanism and have a rotating articulation control
knob disassembled.

FIG. 10 depicts a top perspective detail view of a spur gear articulation
mechanism and end effector of the surgical instrument of FIG. 1 with firing and
frame portions removed.
FIG. 11 depicts a perspective, exploded view of an implement portion of the
surgical instrument of FIG. 1 including a spur gear articulation mechanism.
FIG. 12 depicts a perspective view looking downward, forward and to the right of
a distal portion of the handle portion of the surgical instrument of FIG. 1 partially
cutaway to expose a lateral articulation control mechanism.

FIG. 13 depicts a perspective, exploded view of the lateral articulation control
mechanism of FIG. 12.
FIG. 14 depicts a front elevation view in section of the lateral articulation control
mechanism of FIG. 12.
FIG. 15 depicts a detail view of a locking block in an engaged state of the lateral
articulation control mechanism of FIG. 13.
FIG. 16 depicts a detail view of the lateral articulation control mechanism of FIG.
13 in a disengaged state.
DETAILED DESCRIPTION OF THE INVENTION
Turning to the Drawings, wherein like numerals denote like components
throughout the several views, FIGS. 1-3 depict a surgical instrument, which in the
illustrative embodiment is more particularly a surgical stapling and severing
instrument 10, that is capable of practicing the unique benefits of the present
invention. In particular, the surgical stapling and severing instrument 10 is sized
for insertion, in a nonarticulated state as depicted in FIG. 1, through a trocar
cannula passageway to a surgical site in a patient for performing a surgical
procedure. Once an articulation mechanism 11 and a distally attached end
effector 12 are inserted through the cannula passageway, the articulation
mechanism 11 may be remotely articulated, as depicted in FIG. 2, by an
articulation control 13. Thereby, the end effector 12 may reach behind an organ
or approach tissue from a desired angle or for other reasons. For instance, a
firing mechanism, advantageously depicted as an E-beam firing bar 14 (depicted
in FIG. 3), that severs clamped tissue, engages an elongate channel 16 and a
pivotally attached anvil 18.

The surgical and 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 articulating mechanism 11 and 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. Thereafter, a release
button 30 is depressed to release the clamped tissue.
An outmost closure sleeve 32 of the shaft 23 longitudinally translates in
response to the closure trigger 26 to pivotally close the anvil 18. Specifically, a
distal portion, or closure ring 33, of the closure sleeve 32 with respect to the
articulation mechanism 11 is indirectly supported by a frame 34 of the implement
portion 22 (partially visible at the articulation mechanism 11). At the articulation
mechanism 11, a proximal portion, or closure tube 35, of the closure sleeve 32
communicates with the distal portion (closure ring) 33. The frame 34 is flexibly
attached to the elongate channel 16 via the articulation mechanism 11, enabling
articulation in a single plane. The frame 34 also longitudinally slidingly supports a
firing drive member 36 that communicates a firing motion from the firing trigger
28 to the firing bar 14. Only the firing bar 14 of the firing drive member 36 is
depicted FIG. 3, but the firing drive member 36 is described below further detail
with regard to various versions of a rotationally controlled articulation mechanism
11.
It will be appreciated that the terms "proximal" and "distal" are used herein with
reference to a clinician gripping a handle of an instrument. Thus, the end effector
12 is distal with respect to the more proximal handle portion 20. It will be further
appreciated that for convenience and clarity, spatial terms such as "vertical" and
"horizontal" are used herein with respect to the drawings. However, surgical
instruments are used in many orientations and positions, and these terms are not
intended to be limiting and absolute.

E-Beam Firing Bar
FIGS. 3-5 depict the end effector 12 employing the E-beam firing bar 14 to
perform a number of functions. In FIG. 3, the firing bar 14 is proximally
positioned, allowing an unspent staple cartridge 37 to be installed into the
elongate channel 16. In particular, an upper pin 38 of the firing bar 14 resides
within a recess, depicted as an anvil pocket 40 allowing the anvil 18 to be
repeatedly opened and closed. With the end effector closed as depicted in FIG.
4, the firing bar 14 is advanced in engagement with the anvil 18 by having the
upper pin 38 enter a longitudinal anvil slot 42. A lower most pin, or firing bar cap
44, engaged a lower surface of the elongate channel

16 by having the firing bar 14 extend through a channel slot 45. A middle pin 46
slidingly engages a top surface of the elongate channel 16, cooperating with the
firing bar cap 44. Thereby, the firing bar 14 affirmatively spaces the end effector
12 during firing, overcoming pinching that may occur with a minimal amount of
clamped tissue and overcoming staple malformation with an excessive amount of
clamped tissue.
During firing, a distally presented cutting edge 48 between the upper pin 38 and
middle pin 46 of the firing bar enters a proximally presented vertical slot 49 of the
staple cartridge 37, severing tissue clamped between the staple cartridge 37 and
the anvil 18. As shown in FIG. 4, the middle pin 46 actuates the staple cartridge
37 by entering into a firing slot within the staple cartridge 37, driving a wedge
sled 41 into upward camming contact with staple drivers 43 that in turn drive a
plurality of staples 47 out of staple apertures 51 in the staple cartridge 37 into
forming contact with staple pockets 53 on an inner surface of the anvil 18. FIG. 5
depicts the firing bar 14 fully distally translated after completing severing and
stapling tissue.
Two-Axis Handle
With reference to FIGS. 6-7, the handle portion 20 is comprised of first and
second base sections 50 and 52, which are molded from a polymeric material
such as a glass-filled polycarbonate. The first base section 50 is provided with a
plurality of cylindrical-shaped pins 54. The second base section 52 includes a
plurality of extending members 56, each having a hexagonal-shaped opening 58.

The cylindrical-shaped pins 54 are received within the hexagonal-shaped
openings 58 and are frictionally held therein for maintaining the first and second
base sections 50 and 52 in assembly.
A housing cap 60 has a bore 62 extending completely through it for engaging
and rotating the implement portion 22 about its longitudinal axis. The housing cap
60 includes an inwardly protruding boss 64 extending along at least a portion of
the bore 62. The protruding boss 64 is received within a longitudinal slot 66
formed at a proximal portion of the closure sleeve 32 such that rotation of the
housing cap 60 effects rotation of the closure sleeve 32. It will be appreciated
that the boss 64 further extends through frame 34 and into contact with a portion
of the firing drive member

36 to effect their rotation as well. Thus, the end effector 12 (not shown in FIGS.
3-4) rotates with the housing cap 60.
A proximal end 68 of the frame 34 passes proximally through the housing cap 60
and is provided with a circumferential notch 70 that is engaged by opposing
channel securement members 72 extending respectively from the base sections
50 and 52. Only the channel securement member 72 of the second base section
52 is shown. The channel securement members 72 extending from the base
sections 50, 52 serve tsecure the frame 34 to the handle portion 20 such that the
frame 34 does not move longitudinally relative to the handle portion 20.
The closure trigger 26 has a handle section 74, a gear segment section 76, and
an intermediate section 78. A bore 80 extends through the intermediate section
78. A cylindrical support member 82 extending from the second base section 52
passes through the bore 80 for pivotally mounting the closure trigger 26 on the
handle portion 20. A second cylindrical support member 83 extending ] from the
second base section 52 passes through a bore 81 of firing trigger 28 for pivotally
mounting on the handle portion 20. A hexagonal opening 84 is provided in the
cylindrical support member 83 for receiving a securement pin (not shown)
extending from the first base section 50.
A closure yoke 86 is housed within the handle portion 20 for reciprocating
movement therein and serves to transfer motion from the closure trigger 26 to the
closure sleeve 32. Support members 88 extending from the second base section
52 and securement member 72, which extends through a recess 89 in the yoke
86, support the yoke 86 within the handle portion 20.

A proximal end 90 of the closure sleeve 32 is provided with a flange 92 that is
snap-fitted into a receiving recess 94 formed in a distal end 96 of the yoke 86. A
proximal end 98 of the yoke 86 has a gear rack 100 that is engaged by the gear
segment section 76 of the closure trigger 26. When the closure trigger 26 is
moved toward the pistol grip 24 of the handle portion 20, the yoke 86 and, hence,
the closure sleeve 32 move distally, compressing a spring 102 that biases the
yoke 86 proximally. Distal movement of the closure sleeve 32 effects pivotal
translation movement of the

anvil 18 distally and toward the elongate channel 16 of the end effector 12 and
proximal movement effects closing, as discussed below.
The closure trigger 26 is forward biased to an open position by a front surface
130 interacting with an engaging surface 128 of the firing trigger 28. Clamp first
hook 104 that pivots top to rear in the handle portion 20 about a pin 106 restrains
movement of the firing trigger 28 toward the pistol grip 24 until the closure trigger
26 is clamped to its closed position. Hook 104 restrains firing trigger 28 motion by
engaging a lockout pin 107 in firing trigger 28. The hook 104 is also in contact
with the closure trigger 26. In particular, a forward projection 108 of the hook 104
engages a member 110 on the intermediate section 78 of the closure trigger 26,
the member 110 being outward of the bore 80 toward the handle section 74.
Hook 104 is biased toward contact with member 110 of the closure trigger 26 and
engagement with lockout pin 107 in firing trigger 28 by a release spring 112. As
the closure trigger 26 is depressed, the hook 104 is moved top to rear,
compressing the release spring 112 that is captured between a rearward
projection 114 on the hook 104 and a forward projection 116 on the release
button 30.
As the yoke 86 moves distally in response to proximal movement of the closure
trigger 26, an upper latch arm 118 of the release button 30 moves along an
upper surface 120 on the yoke 86 until dropping into an upwardly presented
recess 122 in a proximal, lower portion of the yoke 86. The release spring 112
urges the release button 30 outward, which pivots the upper latch arm 118
downwardly into engagement with the upwardly presented recess 122, thereby
locking the closure trigger 26 in a tissue clamping position.

The latch arm 118 can be moved out of the recess 122 to release the anvil 18 by
pushing the release button 30 inward. Specifically, the upper latch arm 118 pivots
upward about pin 123 of the second base section 52. The yoke 86 is then
permitted to move proximally in response to return movement of the closure
trigger 26.
A firing trigger return spring 124 is located within the handle portion 20 with one
end attached to pin 106 of the second base section 52 and the other end
attached to a pin 126 on the firing trigger 28. The firing return spring 124 applies
a return force to the pin 126 for biasing the firing trigger 28 in a direction away
from the pistol

grip 24 of the handle portion 20. The closure trigger 26 is also biased away from
pistol grip 24 by engaging surface 128 of firing trigger 28 biasing front surface
130 of closure trigger 26.
As the closure trigger 26 is moved toward the pistol grip 24, its front surface 130
engages with the engaging surface 128 on the firing trigger 28 causing the firing
trigger 28 to move to its "firing" position. When in its firing position, the firing
trigger 28 is located at an angle of approximately 45° to the pistol grip 24. After
staple firing, the spring 124 causes the firing trigger 28 to return to its initial
position. During the return movement of the firing trigger 28, its engaging surface
128 pushes against the front surface 130 of the closure trigger 26 causing the
closure trigger 26 to return to its initial position. A stop member 132 extends from
the second base section 52 to prevent the closure trigger 26 from rotating
beyond its initial position.
The surgical stapling and severing instrument 10 additionally includes a
reciprocating section 134, a multiplier 136 and a drive member 138. The
reciprocating section 134 comprises a wedge sled, or wedge sled, in the
implement portion 22 (not shown in FIG. 6-7) and a metal drive rod 140.
The drive member 138 includes first and second gear racks 141 and 142. A first
notch 144 is provided on the drive member 138 intermediate the first and second
gear racks 141, 142. During return movement of the firing trigger 28, a tooth 146
on the firing trigger 28 engages with the first notch 144 for returning the drive
member 138 to its initial position after staple firing. A second notch 148 is located
at a proximal end of the metal drive rod 140 for locking the metal drive rod 140 to
the upper latch arm 118 of the release button 30 in its unfired position.

The multiplier 136 comprises first and second integral pinion gears 150 and 152.
The first integral pinion gear 150 is engaged with a first gear rack 154 provided
on the metal drive rod 140. The second integral pinion gear 152 is engaged with
the first gear rack 141 on the drive member 138. The first integral pinion gear 150
has a first diameter and the second integral pinion gear 152 has a second
diameter that is smaller than the first diameter.

Rotational Articulation Control
With reference to FIGS. 6-9, the handle portion 20 advantageously incorporates
the articulation control 13 that both rotates the implement portion 22 about the
longitudinal axis of the surgical instrument 10 and articulates the end effector 12
to an angle with the longitudinal axis. A hollow articulation drive tube 200 is
concentrically located within the closure sleeve 32 and is operably coupled to an
actuation lever 202 such that rotation of actuation lever 202 rotates tube 200
about the longitudinal axis and causes perpendicular rotation or articulation of the
closure ring 250 and end effector 12. This articulation of the closure ring 250
corresponds to the degree and direction of rotation of actuator lever 202 viewed
and manipulated by the clinician. In the illustrative version, the relationship is one
to one, with the degree of rotation of the actuator lever 202 corresponding to the
degree of articulation from the longitudinal axis of the shaft 23, thus providing an
intuitive indication to the clinician. It will be appreciated that other angular
relationships may be selected.
The articulation control 13 includes a pair of mirrored articulation transmission
housings 204 that are attached to the housing cap 60. Moreover, the articulation
transmission housing 204 includes longitudinally aligned external tabs 206 that a
clinician twists to effect rotation of the articulation transmission housing 204, and
thus of the end effector 12, about the longitudinal axis of the implement portion
22. The actuator lever 202 is attached to a cylindrical articulation body 208 that
resides within a cylindrical recess 210 opening generally upward and
perpendicular to the shaft 23. The lowermost portion of the articulation body 208
includes prongs 212 that snap fit into an opening 214 in the articulation
transmission housing 208 near to the shaft 23, the prongs 212 preventing the
articulation body 208 from being withdrawn from the cylindrical recess 210.

Annularly presented gear teeth 216 are located about the lower portion of the
articulation body 208 and mesh with teeth 218 on an articulation yoke 220. The
articulation yoke 220 straddles an articulation rectangular window 222 formed in
the closure sleeve 32. Closure sleeve 32 is slidably moveable within the
articulation control 13 (in the longitudinal direction) to close and open the end
effector 12. The articulation drive tube 200 moves longitudinally with the closure
sleeve 32 relative to

the fixed articulation control 13. Window 222 provides clearance for a boss 224
inwardly presented from the articulation yoke 220 that passes through the
rectangular window 222 to engage a slot 226 in the articulation drive tube 200,
longitudinally positioning the articulation drive tube 200 for rotational motion. The
hollow articulation drive tube 200 extends longitudinally within the closure sleeve
32 from the articulation mechanism 11 and terminates distally before the locking
tabs 227 of the closure sleeve 32. The tabs 227 are inwardly bent behind the
proximal face of the articulation drive tube 200 and thereby retaining the
articulation drive tube 200 in the shaft 23.
It should be appreciated that the articulation transmission housing 204 is
operatively associated to the closure tube 35 of the shaft 23. The housing cap 60
retains the articulation yoke 220 in the articulation transmission housing 204 and
retains the articulation control 13 within the handle portion 20 by presenting
proximally an outer diameter circular groove 228 that engages a circular inward
lip 230 at the distal opening of the assembled base sections 50, 52.
FIGS. 10 and 11 depict the gear articulation mechanism 11 of FIGS. 1-2 in the
form of a spur gear articulation mechanism 240, which is generally the same as
described above but with additional articulation driving components on the other
side of the articulation mechanism 240 to thereby increase performance.
Articulation mechanism 240 has a rotatable hollow articulation drive tube 242 that
is concentrically located within closure sleeve 32 and has a distally projecting
gear section 244 about a first circumference portion 246. Gear section 244
meshes with a spur gear 248 attached to and proximally projecting from closure

ring 250 which pivots about pins 253 extending through first and second pivot
points 252, 260 projecting distally from the closure sleeve 32. Thus, an
articulation pivot axis passes through both the first and second pivot points 252,
260 and pins 253 rotatably couple closure ring 250 to the closure sleeve 32.
Rotation of drive 242 engages the gears 242 and 248 and articulates closure ring
250 about first and second pivot points 252, 260
To increase the effective surface area of gear contact between the hollow
articulation drive tube 242 and the closure ring 250, a second circumference
portion 254 of the hollow articulation drive tube 242 has a recessed distally
projecting gear

section 256 extending therefrom. Gear section 256 is operably coupled to a
second spur gear 258 attached to and proximaily projecting from an opposite
lateral side of the closure ring 250 by a reversing gear 262 pivotally supported by
the frame 34. Reversing gear 262 engages both the recessed distally projecting
gear section 256 on one side and the second spur gear 258 of the closure ring
250 on the other.
When the closure trigger 26 is actuated, both the hollow articulation drive tube
242 and pivotally attached closure tube 250 of the closure sleeve 32 are moved
distally to close the anvil 18. The closure tube 35 of the closure sleeve 32 is
spaced away from the closure ring 33 by pivot points 252, 260 pinned to pivot
holes 264 and 266 centered in spur gears 248, 258, and a frame opening 268
that extends therethrough. The frame opening 268 provides clearance so that the
proximal edges of the closure ring 33 and the distal edges of the closure tube 35
of the closure sleeve 32 do not collide during articulation.
FIG. 11 depicts in disassembled form an implement portion 270 that includes the
spur gear articulation mechanism 240. A frame 272 is longitudinally attachable to
the handle portion 20 (depicted in FIGS. 1 and 2) with a bushing 274 on its
proximal end for rotatingly engagement thereto. A frame trough 276 formed by an
opening 278 longitudinally aligned with the center of the frame 272 is longer than
a firing connector 280 that slides longitudinally within the frame trough 276. The
proximal end of the firing connector 280 rotatingly engages the distal end of the
metal drive bar 140 (depicted in FIG. 6). The distal end of the firing connector
280 includes a slot 282 that receives a proximal end of the firing bar 14, attached
therein by pins 284. A more distal portion of the firing bar 14 is positioned within
a lower groove 286 in a firing bar slotted guide 288 that is distally engaged with
an articulating frame member 290 and the frame 272.

Articulating frame member 290 has a channel-anchoring member 292 that
distally attaches to an attachment collar 294 of a proximal portion in the elongate
channel 16. The firing bar 14 passes through a lower slot 295 in the articulating
frame member 290. The articulating frame member 290 is spaced away from the
distal end of the frame 272 by the firing bar slotted guide 288 and flexibly
attached thereto for articulation by a resilient connector 296. A widened proximal
end 298 of

proximally directed teeth rack 432 with vertically aligned teeth 434 that engage
an upper portion 436 of a vertically-aligned elongate gear 438. A lower portion
440 of the vertically aligned elongate gear 438 engages a right-facing gear rack
442 connected proximally to the articulation control rod 406.
Thus, as the lateral control actuator 426 is moved laterally to the left, its
proximally directed teeth rack 432 rotates the elongate gear 438 counter
clockwise, as viewed from the top, thereby moving the right-facing gear rack 442
proximally drawing the articulation control rod 406 proximally. Thereby, the end
effection 403 is articulated to the left since the articulation control rod 406
attaches at a pin 444 on the proximal end 420 of the end effector to the left of the
pivot 412.
It will be appreciated that various other lateral-to-longitudinal gear mechanisms
may be employed. For instance, having both gear racks 432,442 engage the
elongate gear 438 from opposite sides with respect to their respective
engagements that are depicted would accomplish a like result. Moreover,
reversing the engagement in only one of the two could be done in conjunction
with reversing the attachment of the longitudinal control rod 406 from the left of
the pivot 412 to the right. As yet a further alternative, switching one of these
three orientation or all three to their respective opposite configuration may
inverse the control, articulating the end effector 408 in an opposite direction as
the lateral control actuator 426.

It should be further appreciated that the depicted lateral-to-longitudinal gear
mechanism creates a degree of articulation that is related to the distance of a
pivoting connection at pin 444 of the longitudinal control rod 406 to the end
effector 408 normal to the pivot axis. Varying this amount of articulation travel
relative to the movement of the lateral control actuator 426 may be achieved by
gear relationship between the gear rack 432 of the lateral control actuator 426
and the gear rack 442 connected to the longitudinal control rod 406. For
instance, the elongate gear 438 may have an upper portion having a diameter
that differs from the diameter of the lower portion.

LATERAL-TO-ROTATIONAL CONTROL OF AN ARTICULATION MECHANISM
FIGS. 13-16 depict a lateral articulation control 500 that provides similar intuitive
clinician control features for an articulating surgical instrument 502 similar to that
described for FIGS 1-11. In particular, the lateral articulation control 500
converts a lateral motion into a rotational motion transferred by an articulation
drive tube 504 to an articulation mechanism (not shown in FIGS 13-16). A
downward projecting gear rack 506 is coupled to a lower side 508 of a lateral
control actuator 510 for engaging with longitudinally aligned grooves 512 on a
top face of the articulation drive tube 504.
An articulation backdrive lockout 516 is advantageously incorporated into the
lateral articulation control 500 to prevent a force upon the end effector (not
depicted in FIGS 13-16) from changing the amount of articulation. In particular,
interposed between the articulation control actuator 510 and the gear rack 506 is
a rack plate 518 that includes a central opening 520 containing a flexible X-
shaped locking member 522. Te articulation control actuator 510 includes two
deflection blades 524,526 that downwardly project into the central opening 520
of the rack plate 518 and are positioned respectively in a distal and a proximal
quadrant defined by the X-shaped locking member 522 with respect to a top
view depicted in FIGS 15-16. The gear rack 506 includes two drive blades

532,534 that upwardly project into the central opening 520 of the rack plate 518
and are positioned respectively in the left and right quadrants 536,538 defined
by the X-shaped locking member 522. The central opening 520 of the rack plate
518 is shown as being generally rectangular in shape, but with ramped teeth
540, each presenting an abutting surface 542 inwardly facing and longitudinally
aligned. These ramped teeth 540 are placed along a right and left portion
544,546 of a distal edge 548 to ratchedly contact right and left distal arms
550,552 respectively of the X-shaped locking member 522. The ramped teeth
540 are also placed along a right and left portion 554,556 of a proximal edge 558
of the rectangular window 520 to ratchedly contact right and left proximal arms
560,562 of the X-shaped locking member 522.

With particular reference to FIG. 14, the gear rack 518 is illustrated as attached
to a knob 564 and thus does not laterally translate with the articulation control
actuator 510 or the gear rack 506. Lateral movement of the articulation control
actuator 510 is transferred through the articulation backdrive lockout 516 formed
inside the rectangular window 520 of the rack frame 518. By contrast, a
backdriven lateral movement of the articulation drive tube 504 and hence the
gear rack 506 is reacted by the articulation backdrive lockout 516 into the rack
frame 518 and into the knob 560. Thus movement of the articulation drive tube
504 is arrested.
In use, as depicted in FIG. 15, the lateral articulation control 500 is centered.
Thereby, a visual indication is given to the clinician by the equally extended left
and right ends 566, 568 of the articulation control actuator 510. The deflection
blades 524, 526 are centered on the X-shaped lockout member 522, exerting no
force on the arms 550, 552, 560, 562, which are thereby allowed to extend
toward their uncompressed state into abutting contact with the ramped teeth 540,
preventing lateral movement of the X-shaped lockout member 522. The drive
blades 532, 534 of the gear rack 506 are in opposing contact on each side of the
«
X-shaped lockout member 522. Any lateral force transferred from the articulation
drive tube 504 into the gear rack 506 through the drive blades 532, 534 is
reacted through the X-shaped lockout member 522 into the gear rack 506,
preventing movement.
By contrast, as depicted in FIG. 16, when a clinician moves the articulation
control actuator 510 to one lateral side, the deflection blades 524, 526 contact a

pair of proximal and distal arms (the left ones 552, 562 in FIG. 16) compressing
the pair away from contact with the rectangular window 520. Thus, the X-shaped
lockout member 522 is allowed to move in that direction with the trailing pair of
arms (e.g., right ones 550, 560 in FIG. 16) ratcheting along. This lateral
movement is allowed to continue until the leading arms 552, 562 encounter the
lateral extend of the rectangular window 520 as depicted. The drive blades 532,
534 of the gear rack 506 move with the X-shaped lockout member 522 and thus
ultimately the end effector (not shown in FIG. 16) also articulates in response.
The present invention has been discussed in terms of endoscopic procedures
and apparatus. However, use herein of terms such as "endoscopic", should not
be

construed to limit the present invention to a surgical stapling and severing
instrument for use only in conjunction with an endoscopic tube (i.e., trocar). On
the contrary, it is believed that the present invention may find use in any
procedure where access is limited to a small incision, including but not limited to
laparoscopic procedures, as well as open procedures.
While the present invention has been illustrated by description of several
embodiments and while the illustrative embodiments have been described in
considerable detail, it is not the intention of the applicant to restrict or in any way
limit the scope of the appended claims to such detail. Additional advantages and
modifications may readily appear to those skilled in the art.
For yet another example, although an illustrative handle portion 20 described
herein is manually operated by a clinician, it is consistent with aspects of the
invention for some or all of the functions of a handle portion to be powered (e.g.,
pneumatic, hydraulic, electromechanical, ultrasonic, etc.). Furthermore, controls
of each of these functions may be manually presented on a handle portion or be
remotely controlled (e.g., wireless remote, automated .. remote console, etc.).
As yet an additional example, although a simultaneous stapling and severing
instrument is advantageously illustrated herein, it would be consistent with
aspects of the invention rotationally controlled articulation with other types of end
effectors, such as grasper, cutter, staplers, clip applier, access device, drug/gene .
therapy delivery device, and a energy device using ultrasound, RF, laser, etc.

We Claim:
1. A surgical instrument (10), comprising:
an end effector (12);
a shaft (23) having a longitudinal axis and having an articulation motion
transfer member operatively configured to transfer an articulation motion;
an articulation mechanism (11) responsive to the articulation motion from the
articulation motion transfer member and pivotally coupling the end effector
(12) to a distal end of the shaft (23) in a single plane bisected by the
longitudinal axis to articulate selectively in a first direction and a second
direction; and
an articulation control (13) coupled to a proximal portion of the shaft (23),
comprising:
an actuator (202) laterally and linearly positionable by a user, a lateral motion
therefrom aligned to the single plane to correspond to the selected one of
the first and second direction of articulation, and
a motion conversion mechanism (240) coupled to the actuator (202) and to
the articulation mechanism (11) and operably configured to convert the
lateral motion from the articulation control (13) to an articulation motion.
2. The surgical instrument as claimed in claim 1, wherein the articulation
control comprises a longitudinal control rod coupled the end effector at an
attachment offset from a pivot axis of the articulation mechanism, wherein
the motion conversion mechanism is operably configured to convert the
lateral motion to a longitudinal motion.

3. The surgical instrument as claimed in claim 2, wherein the motion
conversion mechanism comprises a gear means for coupling the lateral
movement to the longitudinal motion.
4. The surgical instrument as claimed in claim 2, wherein the motion
conversion mechanism comprises:
a lateral gear rack coupled to the articulation control;
a gear engaged to the gear rack of the articulation control; and
a longitudinal gear rack coupled to the longitudinal control rod and
engaged to the gear.
5. The surgical instrument as claimed in claim 1, wherein the shaft comprises
in articulation drive tube transferring the articulation motion as a
rotational motion to the articulation mechanism.
6. The surgical instrument as claimed in claim 5, wherein the motion
conversion mechanism comprises a gear means for coupling the lateral
movement to the rotational motion.
7. The surgical instrument as claimed in claim 5, wherein the motion
conversion mechanism comprises a lateral gear rack coupled to the
articulation control and the articulation drive tube includes a gear section
engaged to the lateral gear rack.

8. The surgical instrument as claimed in claim 7, wherein the motion
conversion mechanism comprises a backdrive lockout mechanism coupling
the articulation control to the lateral gear rack.
9. The surgical instrument as claimed in claim 8, wherein the backdrive
lockout mechanism comprises:
a frame having a window;
a lockout member laterally locked into position with the window of the frame
and coupled to the lateral gear rack; and
a deflection member coupled to the articulation control and positioned to
disengage and to laterally position the lockout member.
10.The surgical instrument as claimed in claim 8, wherein the backdrive
lockout mechanism comprises a means for preventing transferring motion
from the articulation drive tube to the articulation mechanism.
11. A surgical instrument as claimed in claim 1, comprising:
a handle portion coupled to the shaft operably configured to produce
the actuating motion;
a lateral articulation control laterally positionable by a user and
operably configured to produce the rotational motion.

12.The surgical instrument as claimed in claim 11, wherein the lateral
articulation control comprises a backdrive lockout mechanism.
13.A surgical instrument comprising:
a handle portion operable to produce a firing motion, a closing motion,
and an articulation motion;
a shaft coupled to the handle portion operable to separately transfer the
firing motion, the closing motion, and the articulation motion;
an elongate channel coupled to the shaft;
an anvil pivotally coupled to the elongate channel, responsive to the
closing motion from the shaft;
a firing device including a distally presented cutting edge longitudinally
received between the elongate channel and the anvil;
an articulation mechanism pivoting the elongate channel from the shaft in
response to the articulation motion; and
a lateral articulation control laterally positionable by a user and operably
configured to produce the articulation motion.
14.The surgical instrument as claimed in claim 13, wherein the lateral
articulation control comprises a backdrive lockout mechanism.

15.A surgical instrument, comprising:
a shaft defining a longitudinal axis of the surgical instrument;
an end effector movable from a first position in alignment with said
longitudinal axis to a second position at an angle with said longitudinal axis;
a rotatable member operably coupled with said end effector such that
rotation of said member moves said end effector from said first to said
second position; and
a lateral control member moveable laterally to said longitudinal axis and
operably coupled to said rotatable member, wherein lateral movement of said
lateral control member moves said end effector from said first to said second
position.

The invention relates to a surgical instrument (10), comprising an end effector (12); a shaft (23) having a longitudinal axis and having an articulation motion transfer member operatively configured to transfer an articulation motion; an
articulation mechanism (11) responsive to the articulation motion from the articulation motion transfer member and pivotally coupling the end effector (12) to a distal end of the shaft (23) in a single plane bisected by the longitudinal axis to articulate selectively in a first direction and a second direction; and an
articulation control (13) coupled to a proximal portion of the shaft (23), comprising: an actuator (202) laterally and linearly positionable by a user, a lateral motion therefrom aligned to the single plane to correspond to the selected one of the first and second direction of articulation, and a motion
conversion mechanism (240) coupled to the actuator (202) and to the articulation mechanism (11) and operably configured to convert the lateral motion from the articulation control (13) to an articulation motion.

Documents:

415-kol-2004-abstract.pdf

415-kol-2004-claims.pdf

415-kol-2004-correspondence.pdf

415-kol-2004-description (complete).pdf

415-kol-2004-drawings.pdf

415-kol-2004-examination report.pdf

415-kol-2004-form 1.pdf

415-KOL-2004-FORM 15.pdf

415-kol-2004-form 18.pdf

415-kol-2004-form 2.pdf

415-kol-2004-form 26.pdf

415-kol-2004-form 3.pdf

415-kol-2004-form 5.pdf

415-KOL-2004-FORM-27.pdf

415-kol-2004-reply to examination report.pdf

415-kol-2004-specification.pdf

415-kol-2004-translated copy of priority document.pdf


Patent Number 235093
Indian Patent Application Number 415/KOL/2004
PG Journal Number 26/2009
Publication Date 26-Jun-2009
Grant Date 24-Jun-2009
Date of Filing 09-Jul-2004
Name of Patentee ETHICON ENDO-SURGERY, INC.
Applicant Address 4545 CREEK ROAD, CINCINNATI, OH
Inventors:
# Inventor's Name Inventor's Address
1 KENNETH S. WALES 9675 SWAN PLACE, MASON, OH 45040
2 KENNETH S. WALES 9675 SWAN PLACE, MASON, OH 45040
PCT International Classification Number A61B 17/072
PCT International Application Number N/A
PCT International Filing date
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 10/615972 2003-07-09 U.S.A.