Multifunctional tool and method for minimally invasive surgery

Abstract

An apparatus and method for minimally invasive surgery. The apparatus can comprise a tool which includes a multi-functioning end effector for insertion into a patient, a user control adapted for use by the surgeon external of the patient, and an intermediate section between the end effector and the user control to translate control instructions from the user control through an actuating mechanism to operate the end effector in one of at least two different functioning states. No instrument exchange is necessary to change between states. The actuation mechanism could be a manually operated mechanical mechanism. Alternatively, it could be partially or fully electromechanical or electrical or electronic. According to one aspect, the end effector is a rigid link mechanism. According to another aspect, the end effector could be a compliant mechanism, at least in part. Another aspect of the invention includes the ability of the end effector to have at least some articulation in addition to grasping and cutting functions.

1 . An end-effector for utilization at a surgical site on or in a patient comprising: 
 (a) a working end adapted for surgical functioning and including an interface adapted for operative connection to an actuating mechanism;    (b) said working end being configurable to 
 (1) a first state capable of a first surgical function by translation of one portion of the working end towards another portion of the working end in a first direction;  
 (2) a second state capable of a second surgical function by translation of the one portion of the working end towards another portion of the working end in a second direction;  
 (3) wherein selection of said first or second state is effected through said interface.  
   
   
   
       2 . The end-effector of  claim 1  wherein said interface comprises a non-compliant mechanism.  
   
   
       3 . The end-effector of  claim 1  wherein said interface comprises a compliant mechanism.  
   
   
       4 . The end-effector of  claim 1  wherein said one portion comprises a first grasping surface moveable in a first plane.  
   
   
       5 . The end-effector of  claim 4  wherein said another portion is a second grasping surface having a section in said first plane and having a section that is moveable outside of said first plane.  
   
   
       6 . The end-effector of  claim 1  wherein said one portion is a first jaw pivotable in a first plane and said another portion is a second jaw positionable in said first plane.  
   
   
       7 . The end-effector of  claim 6  wherein said portion of said second jaw is pivotable in a second plane.  
   
   
       8 . The end-effector of  claim 1  wherein said first surgical function is grasping and said second surgical function is cutting action.  
   
   
       9 . The end-effector of  claim 1  further comprising a third state for a third surgical function.  
   
   
       10 . The end-effector of  claim 9  wherein the third surgical function is articulation of the working end.  
   
   
       11 . The end-effector of  claim 1  in combination with an actuating mechanism.  
   
   
       12 . The end-effector of  claim 9  wherein said first surgical function comprises grasping and said third state comprises articulation of said grasping function relative to a reference position.  
   
   
       13 . The end-effector of  claim 1  wherein the end-effector is adapted for minimally invasive surgery.  
   
   
       14 . A method of providing multiple surgical functioning at a surgical site on or in a patient comprising: 
 (a) configuring a working end of a surgical tool for a first surgical function by translation of the one portion of the working end towards another portion of the working end in a first direction;    (b) reconfiguring the working end for a second surgical function without exchange of said working end by translation of the one portion of the working end towards another portion of the working end in a second direction.    
   
   
       15 . The method of  claim 14  wherein selection of said first or second surgical functions is effected through an interface.  
   
   
       16 . The method of  claim 14  wherein said interface comprises a non-compliant mechanism.  
   
   
       17 . The method of  claim 14  further comprising a third surgical function.  
   
   
       18 . The method of  claim 17  wherein the third surgical function is articulation of the working end.  
   
   
       19 . A multifunction end-effector tool for use in minimally invasive surgery, comprising: 
 (a) a mechanism adapted to be inserted through an incision in a patient's body, the mechanism comprising;    (b) a tool head, the tool head including a pair of jaws pivotal about a first axis so as to provide a first function and pivotal about a second axis so as to provide a second function; and    (c) an interface adapted for operative communication with a control external of the patient's body and to an actuator operatively connected to the tool head to move the jaws in response to user input from a control.    
   
   
       20 . The tool of  claim 19  wherein the jaws each have a grasping surface and a cutting edge.  
   
   
       21 . The tool of  claim 19  wherein each jaw includes an inner end pivotal about the first axis and an outer end pivotal about the second axis.  
   
   
       22 . The tool of  claim 21  wherein the outer ends of the jaws are pivotable in opposite directions for the cutting action.  
   
   
       23 . The tool of  claim 21  wherein the outer ends of the jaws are pivotable in the same direction about the second axis to provide for articulated grasping and cutting.  
   
   
       24 . The tool of  claim 19  further comprising an actuator which comprises a non-compliant mechanism.  
   
   
       25 . A surgical instrument for performing multiple surgical tasks comprising: 
 (a) a shaft having a proximal portion and a distal portion;    (b) a handle positioned on the proximal portion of the shaft;    (c) jaws pivotable relative to each other, positioned on the distal portion of the shaft; and    (d) an actuation system for imparting articulation motion to the jaws.    
   
   
       26 . The surgical instrument of  claim 25  wherein the pivotable jaws comprise multifunctional scissors, a grasper, a dissector, a cauterizer, or an irrigator.  
   
   
       27 . The surgical instrument of  claim 25  wherein the actuation system comprises a mechanical actuator, an electrical actuator, a pneumatic actuator, a hydraulic actuator, an electroactive material, or a combination thereof.  
   
   
       28 . The surgical instrument of  claim 25  wherein said instrument is configured for minimally invasive surgical tasks.  
   
   
       29 . The surgical instrument of  claim 25  wherein multifunctionality of the pivotable jaws is enabled by a non-compliant mechanism.  
   
   
       30 . The surgical instrument of  claim 25  further comprising two-part jaws pivotable relative to each other, mounted on the distal portion of the shaft, said jaws having a proximal portion and a distal tip, wherein the tips of said jaws are able to articulate in a plane perpendicular to a plane of jaw opening and closing.  
   
   
       31 . The surgical instrument of  claim 30  wherein the jaw actuation system is electrically linked to an electroactive material embedded within, bonded to, or connected to the two-part jaws for effecting movement of the jaws from a closed position to an actuated position; for retaining the jaws in the actuated position; and for enabling the jaws to return to the closed position.  
   
   
       32 . The surgical instrument of  claim 25  wherein the actuated system comprises a cutting, dissecting, or grasping configuration.  
   
   
       33 . The surgical instrument of  claim 26  wherein the jaws are able to be articulated simultaneously or independently.  
   
   
       34 . The surgical instrument of  claim 26  wherein multifunctionality of the pivotable jaws is enabled by a compliant mechanism.  
   
   
       35 . The surgical instrument of  claim 34  further comprising a static balance mechanism to the actuating mechanism for the compliant mechanism.