GB2571281A

GB2571281A - Surgical grasper instruments

Info

Publication number: GB2571281A
Application number: GB1802841.5A
Authority: GB
Inventors: Martin James Ian; James Wootton Paul
Original assignee: Gyrus Medical Ltd
Current assignee: Gyrus Medical Ltd
Priority date: 2018-02-22
Filing date: 2018-02-22
Publication date: 2019-08-28
Anticipated expiration: 2038-02-22
Also published as: GB2571281B; GB201802841D0

Abstract

Surgical grasper instrument comprising: a body 2; fixed grip 4 and movable actuation grip 16; an actuation shaft 6; and first and second opposed jaws [8, 10, figure 1] at the distal end of the actuation shaft 6. The actuation grip is arranged to move the actuation shaft with respect to the body such that the first jaw is rotatable with respect to the second jaw, between open and closed positions. The instrument is provided with an actuation indicator for providing an indication to a user of the device of a position of the actuation grip corresponding to an intermediate position of the first and second jaws, the intermediate position being between the open and closed positions. The actuation indicator may comprise a first engagement element defining a series of teeth 34 extending from the actuation grip, and second engagement element 40 having portion 42 which may be biased by means 44 to engage with the teeth 34. The shaft may include a measurement scale 54 or visual indicator corresponding to jaw position. This allows a user to determine jaw position when they cannot be viewed.

Description

SURGICAL GRASPER INSTRUMENTS

The present invention relates to surgical instruments, and, in particular, to surgical graspers.

BACKGROUND OF THE INVENTION

Surgical graspers are used by surgeons to hold and retrieve tissue and other material during operations. Such graspers incorporate a pair of movable jaws which are located at a distal end of a shaft of a grasper instrument. The movable jaws are actuated by an actuation handle located at a proximal end of such an instrument. The surgeon using the device typically squeezes the actuation handle to close the jaws in order to grasp tissue to be retrieved.

Such surgical graspers are typically used in combination with host instruments, such as morcellators and cannulae. In such a combination, the graspers extend through an internal channel of the host instrument and are arranged so that the jaws can be retracted into the internal channel, in order to retrieve the relevant tissue.

However, previously considered surgical graspers do not provide an indication of jaw position relative to an inside diameter of the other instrument. Grasper jaw position is difficult for a user to determine accurately as the distal end of the grasper jaws remains within the patient with associated limited view. If grasper jaws have been opened too far, then they are unable to be withdrawn through the shaft of the host instrument. In that case, the jaws become locked out against the inside diameter of the instrument.

In the example of a bipolar morcellator, unnecessary electrosurgical smoke may be generated as the grasper remains stationary due to being locked out against the entry to the internal channel of the host instrument. In such a stationary position, the electrosurgical energy cannot resect the tissue effectively and continually applies energy to the same tissue area, thereby generating electrosurgical smoke with no resection benefits. With mechanical morcellators, having the grasper jaws in a locked-out position can cause damage to the cutting edge of the mechanical blades of the morcellator. Blunting of such mechanical blades decreases the efficiency of the cut which increases procedure time, fatigue and frustration.

It is therefore desirable to provide a surgical grasper instrument that can overcome the drawbacks of the previously considered designs.

SUMMARY OF THE INVENTION

Aspects of the present invention are set out in the attached claims.

According to an aspect of the present invention, there is provided a surgical grasper instrument comprising a body, a fixed grip which extends from the body, an actuation shaft that extends from the body, an actuation grip movably mounted on the body, and first and second opposed jaws located at the distal end of the actuation shaft, the first and second jaws having respective first and second distal outer surfaces, the first jaw being rotatable with respect to the second jaw between an open position in which the first and second distal outer surfaces are separated by a first distance, and a closed position in which the first and second distal outer surfaces are separated by a second distance, the second distance being less than the first distance, wherein the actuation shaft is connected with at least the first jaw, and is movable with respect to the body between a first position in which the jaws are in the open position, and a second position in which the jaws are in the closed position, and wherein the actuation grip is arranged to move the actuation shaft between the first and second positions thereof, and wherein the surgical grasper instrument further comprises an actuation indicator for providing an indication to a user of the device of a position of the actuation grip corresponding to an intermediate position of the first and second jaws in which the first and second distal ends are separated by a third distance, the third distance being greater than the first distance and less than the second distance.

In one example, the actuation indicator comprises a first engagement element extending from the actuation grip towards the fixed grip, the first engagement element defining a series of engagement teeth therealong; and a second engagement element extending from the fixed grip towards the actuation grip, the second engagement element defining an engagement portion for engagement with the engagement teeth of the first engagement element, wherein the first engagement tooth of the series is indicative of the intermediate position of the first and second.

In such an example, the first engagement tooth of the series may have a height greater than the remaining teeth in the series.

In such an example, each tooth in the series may define an engagement surface which extends substantially perpendicularly to the direction of the first engagement element.

In such an example, the second engagement element may be biased towards the first engagement element.

In one example, the actuation shaft includes a measurement scale.

One example further comprises a visual indicator actuated by the second engagement element, the visual indicator being indicative of the jaws being in the intermediate position.

In one example, the actuation grip is mounted on a pivot point for rotation with respect to the body and fixed grip, the actuation grip being rotatable about the pivot point between the released and engaged positions.

BRIEF DESCRIPTION OF THE DRAWINGS

Figure 1 is a schematic side view of a surgical grasper instrument embodying the present invention;

Figures 2, 3 and 4 are schematic side views of jaws of the surgical grasper instrument of Figure 1, in respective positions;

Figure 5 is a schematic side view of an actuation portion of the surgical grasper instrument of Figure 1;

Figure 6 is a schematic enlarged view of an actuation indicator of the surgical grasper instrument of Figure 1; and

Figure 7 is a schematic side view of an alternative actuation portion for the surgical grasper instrument of figure 1.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Figure 1 is a schematic side view of surgical grasper instrument embodying the present invention. The surgical grasper instrument 1 comprises a main body 2 from which a fixed grip 4 extends. An actuation shaft 6 extends from the main body 2. The actuation shaft 6 is of any suitable length and is of any suitable stiffness.

First and second jaws 8 and 10 are located at a distal end region of the actuation shaft 6 and are pivotally attached to one another by a first pivot 12 located at the distal end of the actuation shaft 6. An actuation grip 16 is pivotally attached to the body 2 and the fixed grip 4 by a second pivot 18. The actuation grip 16 comprises a first portion 20 which is gripped by the user of the instrument, and a second portion 22 which engages the actuation shaft 6. The actuation grip 16 is pivotable about the second pivot 18 so as to move the actuation shaft 6, thereby actuating the first and second jaws 8 and 10. Use of the grasper instrument will be described in greater detail below.

The first and second jaws 8 and 10 have respective first and second distal outer surfaces 9 and 11. When in use with a host instrument, in order for the jaws 8 and 10 to be retracted within the inner channel of the host instrument, for retrieval of tissue, the distance between the first and second distal outer surfaces 9 and 11 must be less than the internal diameter of the internal channel of the host instrument, as will be described in more detail below.

Figures 2, 3 and 4 illustrate respective positions of the first and second jaws 8 and 10. Figure 2 illustrates an open position of the jaws 8 and 10, in which the distal outer surfaces 9 and 11 are separated by a first distance di. Figure 3 illustrates a closed position of the jaws 8 and 10, in which inner surfaces of the jaws are adjacent one another, and the distal outer surfaces 9 and 11 are separated by a second distance d₂ which is less than the first distance. Figure 4 illustrates an intermediate position of the jaws 8 and 10, in which the distal outer surfaces 9 and 11 are separated by a third distance de. The third distance de is less than the first distance di and greater than the second distance d₂ and is intended to be less than the internal diameter of an internal channel of a host instrument. In the intermediate position, the first and second jaws 8 and 10 are able to be retracted into the internal channel of a host instrument.

Figure 5 illustrates the body 2 and jaw actuation mechanism in more detail. As described above, the actuation shaft 6 extends from the body 2, through a guide portion 24 of the body 2. A fixed grip 4 extends from the body 2, and an actuation grip 16 is pivotally attached to the body 2.

The actuation grip 16 is located on the body 2 using the second pivot 18, which allows the actuation grip 16 to pivot with respect to the body 2 and fixed grip 4. The first portion 20 of the actuation grip 16 is located to a first side of the second pivot 18, and the second portion 22 of the actuation grip 16 is located to a second side of the pivot 18, opposite to the first side. The second portion 22 of the actuation grip is attached to a proximal end of the actuation shaft 6. This arrangement of the actuation grip 16 allows the actuation shaft 6 to be moved linearly with respect to the elongate shaft 6, by rotation of the actuation grip 16 with respect to the fixed grip 4. In use, a surgeon’s hand grips the fixed and actuation grips 4 and 16. Squeezing the grips together causes the actuation shaft 6 to be pulled in a proximal direction (in the direction of arrows A in Figure 5). Pulling the actuation shaft 6 in the proximal direction causes the first and second jaws 8 and 10 to move in the direction of the closed position (Figure 3), and thereby grip any tissue located between the jaws 8 and

10.

Moving the actuation grip 16 away from the fixed grip 4 serves to move the actuation shaft 6 in a distal direction (in the direction of arrows B in Figure 5), thereby moving the first and second jaws towards the open position shown in Figure 2.

In an embodiment of the present invention, actuation indicator means 30 are provided for giving the user an indication of the location of the actuation grip 16 that moves the first and second jaws 8 and 10 to the intermediate position. The actuation indicator means 30 thereby provide the user with an indication as to the grip position in which the jaws 8 and 10 may be retracted into the internal channel of a host instrument.

In the example embodiment illustrated in Figures 1 and 5, the actuation indicator means 30 comprises engaging elements located on the fixed grip 4 and on the actuation grip 16. A first engaging element 32 extends from the actuation grip 16 towards the fixed grip 4. The first engaging element 32 defines a series of engagement teeth 34. A second engaging element 40 extends from the fixed grip 4 towards the actuation grip 16 and includes an engagement portion 42 which is engageable with the engagement teeth 34 of the first engaging element 32.

The engagement teeth 34 and the engagement portion 42 are releasably engageable and serve to hold the actuation grip 16, and hence the first and second jaws 8 and 10, in a chosen position with respect to the fixed grip 4. As the actuation grip 16 is squeezed towards the fixed grip 4, the engagement portion 42 engages in turn with the teeth 34 of the first engaging element 32.

In accordance with the principles of the present invention, and as illustrated in more detail in Figure 6, the first engagement tooth 36 in the series of engagement teeth 34 has greater depth than the remaining teeth 38 in the series of teeth 34. This first tooth 36 is the tooth closest to the fixed grip 4 and indicates the relative positions of the fixed grip 4 and actuation grip 16 which results in the first and second jaws being in the intermediate position, and so retractable within the elongate shaft 6.

The first tooth 36 is of larger relative depth with respect to the other teeth 38 in the series. The teeth 36, 38 define respective engagement surfaces 37, 39 against which the engagement portion 42 of the second engaging element 40 engages. The engagement surface 37, 39 extend substantially perpendicularly to the direction of travel of the first engaging element 32, in order that the teeth 36, 38 and engagement portion 42 are held in place in a chosen position. The actuation grip 16 may be biased in a direction away from the fixed grip 4 in order to enhance the engagement of the engagement portion 42 with the teeth 36, 38.

Extending from the engagement surface 37 of the first tooth 36 is an inclined surface 37’ which defines the next tooth 38 in the series, and which provides a guide path for the engagement portion 42. Similarly, an inclined surface 39’ extends from each of the engagement surfaces 39 of the remaining teeth 38 in the series (except the last in the series), again to define the next tooth 38 in the series, and to provide respective guide paths for the engagement portion 42. As the actuation grip 16 is squeezed towards the fixed grip 4, the engagement portion 42 moves over a tooth 36, 38 and engages with the engagement surface 37, 39 of that tooth 36, 38. As the actuation grip 16 is moved further towards the fixed grip 4, the engagement portion 42 follows the inclined path 37’, 39’ up and over the next tooth 38 in the series, then engages with the next engagement surface 39.

In accordance with the principles of one example of the present invention, the height of the first tooth 36 being greater than the height of the remaining teeth 38 in the series means that the first tooth 36 provides a more significant indication of position than the other teeth 38 in the series. In this way, the user experiences a definite indication that the jaws have reached the intermediate position, and so are spaced suitably to be withdrawn into the inner channel of the host instrument.

The second engaging element 40 is held in place on the fixed grip 4 by way of a bias spring 44 which biases the engagement portion 42 towards the first engagement element 32. The bias spring 44 thereby serves to ensure that the engagement portion 42 engages with one of the teeth 36, 38. In order to release the engagement portion 42 from engagement with one of the teeth 36, 38, the second engaging element 40 extends through the fixed grip 4 and is provided with a release lever 46. Actuating the release lever 46 causes the engagement portion 42 to move out of engagement with the first engagement element 32, thereby allowing the actuation grip 16 to move away form the fixed grip 4.

The first engaging element 32 may be adjusted for position relative to the actuation grip 16 in order to adjust the third distance of the first and second jaws 8 and 10. Moving the first engagement tooth 36 away from the fixed grip sets the intermediate position closer to the fully closed position of the first and second jaws 8 and 10. Moving the first engagement tooth 36 towards the fixed grip 4 sets the intermediate position closer to the fully open position of the first and second jaws 8 and 10. In this way, the intermediate position can be set for any particular host instrument. In the example of Figure 5, the first engaging element is held in position on the actuation grip 16 by a retaining means 49, such as a screw. The first engaging element 32 may have a slot through which the retaining means extends, thereby allowing the first engagement element 32 to be moved with respect to the actuation grip 16, and then held in place by the retaining means 49.

In addition to the mechanical indication of position provided by the actuation indicator 30, the instrument may be provided with additional indication means. For example, the fixed grip 4 may be provided with an indicator 48 which is moved from one colour (for example, red) to another colour (for example, green) when the engagement portion 42 engages the first tooth 36. Such an indicator provides an additional indication to the user that the jaws are able to be withdrawn into the elongate shaft 6.

Another indicator may be provided on the actuation shaft 6. As shown in Figure 5, a measurement scale 50 may be provided on the actuation shaft 6 to provide the user with a visual indication of the position of the jaws.

An enhancement to the actuation shaft 6 is illustrated in Figure 7. An adjustable link arm 52 is provided between the actuation shaft 6 and the second portion 22 of the actuation grip 16. The adjustable link arm 52 enables the user to adjust the relative positions of the first and second jaws and the actuation grip. Such adjustment is helpful to fine tune the action of the jaws. The actuation shaft 6 may be provided with a measurement scale 54 in order to provide visual indication of the position of the shaft 6. The adjustable link arm 52 enables the intermediate position of the first and second jaws 8 and 10 to be adjusted for any particular host instrument.

It will be appreciated that any measurement scale may be numeric or may be provided by colour coded zones, or by a combination of the two.

When used in combination with a host instrument having an internal channel, the actuation shaft 6 extends through the internal channel. The internal channel has an internal diameter, and the intermediate position of the first and second jaws 8 and 10 is set such that the jaws are able to be retracted into the internal channel of the host instrument. Adjusting the position of the actuation indicator enables the surgical grasper instrument to be used with any particular host instrument.

Claims

CLAIMS:

1. A surgical grasper instrument comprising:

a body;

a fixed grip which extends from the body;

an actuation shaft that extends from the body;

an actuation grip movably mounted on the body; and first and second opposed jaws located at the distal end of the actuation shaft, the first and second jaws having respective first and second distal outer surfaces, the first jaw being rotatable with respect to the second jaw between an open position in which the first and second distal outer surfaces are separated by a first distance, and a closed position in which the first and second distal outer surfaces are separated by a second distance, the second distance being less than the first distance;

wherein the actuation shaft is connected with at least the first jaw, and is movable with respect to the body between a first position in which the jaws are in the open position, and a second position in which the jaws are in the closed position, and wherein the actuation grip is arranged to move the actuation shaft between the first and second positions thereof, and wherein the surgical grasper instrument further comprises:

an actuation indicator for providing an indication to a user of the device of a position of the actuation grip corresponding to an intermediate position of the first and second jaws in which the first and second distal ends are separated by a third distance, the third distance being greater than the first distance and less than the second distance.

2. A surgical grasper instrument as claimed in claim 1, wherein the actuation indicator comprises:

a first engagement element extending from the actuation grip towards the fixed grip, the first engagement element defining a series of engagement teeth therealong; and a second engagement element extending from the fixed grip towards the actuation grip, the second engagement element defining an engagement portion for engagement with the engagement teeth of the first engagement element, wherein the first engagement tooth of the series is indicative of the intermediate position of the first and second jaws.

3. A surgical grasper instrument as claimed in claim 2, wherein the first engagement tooth of the series has a height greater than the remaining teeth in the series.

4. A surgical grasper instrument as claimed in claim 3, wherein each tooth in the series defines an engagement surface which extends substantially perpendicularly to the direction of the first engagement element.

5. A surgical grasper instrument as claimed in any one of claims 2 to 4, wherein the second engagement element is biased towards the first engagement element.

6. A surgical grasper instrument as claimed in any one of the preceding claims, wherein the first engaging element is moveable with respect to the actuation grip.

7. A surgical grasper instrument as claimed in any one of the preceding claims, wherein the actuation shaft includes a measurement scale.

8. A surgical grasper instrument as claimed in any one of the preceding claims, further comprising a visual indicator actuated by the second engagement element, the visual indicator being indicative of the jaws being in the intermediate position.

9. A surgical grasper instrument as claimed in any one of the preceding claims, wherein the actuation grip is mounted on a pivot point for rotation with respect to the body and fixed grip, the actuation grip being rotatable about the pivot point between the released and engaged positions.

10. A surgical instrument comprising:

an elongate shaft having a hollow interior which has an internal diameter; and a surgical grasper instrument as claimed in any one of the preceding claims, wherein the actuation shaft of the surgical grasper instrument extends through at least part of the elongate shaft of the surgical instrument, and wherein the third distance is less than the internal diameter of the surgical instrument.