Surgical instrument

Abstract

The surgical instrument includes a distal tool, a rigid or flexible elongated shaft that supports the distal tool, and a proximal handle or control member, where the tool and the handle are coupled to the respective distal and proximal ends of the elongated shaft via distal and proximal bendable motion members. Actuation means extends between said distal and proximal members whereby any deflection of said control handle with respect to said elongated instrument shaft causes a corresponding bending of said distal motion member for control of said working member. The proximal movable member comprises a movable ring assembly supported from the handle and adapted for three dimensional motion relative to the handle. A manually rotatable member may be arranged adjacent to the control handle for manually rotating the instrument shaft and working member relative to the control handle. A locking member may be supported from the control handle. The locking member is manually operable by a user and includes a follower the position of which is responsive to the position of the movable members.

1 - 17 . (canceled) 
   
   
       18 . In a medical instrument having a proximal control handle and a distal tool that are intercoupled by an elongated instrument shaft that is meant to pass internally of an anatomic body, proximal and distal movable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, cable actuation means disposed between said movable members and a locking means that is manually operable by a user and that includes a follower the position of which is responsive to the position of said movable members. 
   
   
       19 . The medical instrument of  claim 18  wherein said movable members comprise bendable members, said cable actuation means comprising a first cable set disposed between said bendable members and further including a second cable set coupled between said follower and proximal bendable member. 
   
   
       20 . The medical instrument of  claim 19  wherein the cables of said second set terminate at the distal end of the proximal bendable member. 
   
   
       21 . The medical instrument of  claim 20  wherein both of said bendable members comprise uni-body members that include discs that define slots therebetween, said first cable set extending through both distal and proximal uni-body members while said second cable set extends through only said proximal uni-body member. 
   
   
       22 . The medical instrument of  claim 19  wherein said follower includes a ball and a rider supported on said ball, said second cable set connected to said rider to pivot said rider on said ball in response to bending at said proximal bendable member. 
   
   
       23 . The medical instrument of  claim 22  including a rotation member adjacent said proximal control handle controllable to rotate said tool about its distal tool axis. 
   
   
       24 . The medical instrument of  claim 23  wherein said rotation member includes a pair of legs that define at least one slot for guiding at least one pin of the rider. 
   
   
       25 . The medical instrument of  claim 24  wherein said rotation member includes opposed legs that define opposed slots for receiving opposed pins of the rider. 
   
   
       26 . The medical instrument of  claim 22  wherein said ball is a split ball and said locking means further includes a wedge member that is operable in the locked state to engage the split ball to, in turn, freeze the position of the follower on the ball. 
   
   
       27 . The medical instrument of  claim 18  wherein said locking means comprises a slide button mounted at said handle and a wedge member responsive to said slide button for locking the position of said follower. 
   
   
       28 . The medical instrument of  claim 27  wherein said follower includes a ball and a rider supported on said ball, said ball being split for receiving said wedge member. 
   
   
       29 . The medical instrument of  claim 28  wherein said slide button includes opposed ends that are respectively disposed on opposite sides of the handle and are manually actuable to either lock or unlock the instrument by depression thereof. 
   
   
       30 . In a surgical instrument having a proximal control handle and a distal tool that are intercoupled by an elongated instrument shaft that is meant to pass internally of an anatomic body, proximal and distal movable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, a first cable set disposed between said movable members to transfer control between said movable members, a follower disposed at the proximal control handle and a second cable set disposed between the follower and one of said movable members, the position of said follower being responsive to the position of said movable members. 
   
   
       31 . The surgical instrument of  claim 30  wherein said movable members comprise bendable members and further including a locking member that is manually operable by a user and that is adapted to fix the position of said follower when locked. 
   
   
       32 . The surgical instrument of  claim 31  wherein said second cable set connects between said follower and said proximal bendable member. 
   
   
       33 . The surgical instrument of  claim 31  wherein said follower includes a ball and a rider supported on said ball, said second cable set connected to said rider to pivot said rider on said ball in response to bending at said proximal bendable member. 
   
   
       34 . A medical instrument comprising:
 a control handle;   a distal work member;   a proximal movable member controlled from said control handle;   a distal movable member controlled from said proximal movable member to provide controlled movement of said distal work member;   an instrument shaft that intercouples said proximal and distal movable members and that has proximal and distal ends;   and actuation means coupled between said movable members;   a ball member with an outer spherical surface, said ball member fixedly attached to the proximal end of the instrument shaft;   said proximal movable member comprising a movable ring assembly supported about the ball member and adapted for three dimensional motion relative to the ball member;   said movable ring assembly including an annular rider having an inner concave surface that rides on and conforms to the outer spherical surface of the ball end;   said annular rider constructed and arranged for the three dimensional motion over the outer spherical surface of the ball end to, in turn, control three dimensional motion of said distal movable member.   
   
   
       35 . The medical instrument of  claim 34  further including a locking member mounted on said annular rider and having locked and unlocked states; said locking member in said unlocked state enabling control of said distal work member via said movable members; and said locking member, in said locked state, holding said movable members in a desired fixed position. 
   
   
       36 . The medical instrument of  claim 35  wherein said locking member, in the locked state, fixes the position of the proximal movable member by locking the annular rider to the ball member, said rider formed integrally with the control handle, and said control handle being positionable in three dimensions to control the positioning of the movable ring assembly. 
   
   
       37 . The medical instrument of  claim 34  wherein said distal movable member comprises a uni-body structure. 
   
   
       38 . The medical instrument of  claim 34  wherein said movable ring assembly includes a rotation control member for controlling said distal work member to rotate about a distal work member axis, and wherein the rider is formed as part of the control handle. 
   
   
       39 . The medical instrument of  claim 38  wherein said rotation control member comprises an annular rotation knob that is coupled with the rider while rotationally mounted relative to the rider. 
   
   
       40 . The medical instrument of  claim 39  including a bearing means between the annular rotation knob and the rider and a locking lever mounted on the rider, having locked and unlocked states and for engagement with the ball member in the locked state. 
   
   
       41 . The medical instrument of  claim 34  wherein said actuation means comprises a set of cables, each having proximal and distal cable ends, and that couple between said movable members and further including a rotation knob coupled with the rider while rotationally mounted relative to the rider and a cable retainer supported by said rotation knob and for retaining proximal ends of said cables. 
   
   
       42 . The medical instrument of  claim 34  wherein said movable ring assembly further comprises a locking member mounted on said rider, having locked and unlocked states and for engagement with the ball member in the locked state. 
   
   
       43 . The medical instrument of  claim 34  wherein the actuation means comprises a set of control cables, each having proximal and distal ends, and further including an annular rotation knob that is coupled with the rider while rotationally mounted relative to the rider and means for mounting the proximal ends of the cables at the annular rotation knob. 
   
   
       44 . The medical instrument of  claim 43  wherein said means for mounting includes an annular cable retainer that is secured with and rotates with the rotation knob and further including a locking mechanism mounted on said rider, having locked and unlocked states and for engagement with the ball member in the locked state. 
   
   
       45 . The medical instrument of  claim 44  wherein said locking mechanism includes at least one locking lever mounted on said rider and having a pad means for engagement with the outer spherical surface of the ball member and further including bearing means disposed between the annular rotation knob and the rider for enabling rotation of the rotation knob relative to the rider. 
   
   
       46 . The medical instrument of  claim 43  wherein the proximal movable member also includes an outer bellows having proximal and distal ends with the proximal end thereof attached to the rotation knob for rotation therewith, said outer bellows constructed and arranged to provide torque transmission to the distal work member while providing axial compression and expansion to facilitate a bending action between the movable members. 
   
   
       47 . The medical instrument of  claim 34  including bearing means in the ball member for rotational support of the proximal end of the instrument shaft. 
   
   
       48 . A medical instrument comprising:
 a control handle;   a distal tool;   a proximal movable member controlled from said control handle;   said proximal movable member supported at an open distal end of said control handle;   a distal movable member controlled from said proximal movable member to provide controlled movement of said distal tool from said proximal control handle;   an instrument shaft that intercouples said proximal and distal movable members;   and actuation means coupled between said movable members and including a first cable set disposed between the proximal and distal movable members so that any movement of the proximal movable member causes a corresponding movement of the distal movable member;   and a follower locking mechanism mounted in the control handle adjacent the open distal end of the control handle, spacedly positioned proximally of the proximal movable member and responsive to motion of the proximal movable member;   said follower locking mechanism comprising;   a ball member having an outer spherical surface,   an annular rider having an inner concave surface that rides on and conforms to the outer spherical surface of the ball member,   a second cable set that couples between a distal end of the proximal movable member and said rider,   said annular rider constructed and arranged for motion over the outer spherical surface of the ball member in response to motion of said second cable set,   and a locking member at the control handle for fixing the position of the rider on the ball member,   whereby a control of motion of the proximal movable member from the control handle controls motion of the rider on the ball member.   
   
   
       49 . The medical instrument of  claim 48  wherein said ball member is a split ball and said locking member further includes a wedge member that is operable in the locked state to engage the split ball to, in turn, freeze the position of the rider. 
   
   
       50 . The medical instrument of  claim 48  wherein said proximal movable member comprises a proximal bendable member and further including a rotation knob for supporting the proximal bendable member for rotation therewith, said second cable set being constructed and arranged to be operated independently of the first cable set. 
   
   
       51 . A medical instrument comprising:
 a control handle;   a distal tool;   a proximal movable member controlled from said control handle;   said proximal movable member supported at an open distal end of said control handle;   a distal movable member controlled from said proximal movable member to provide controlled movement of said distal tool from said proximal control handle;   an instrument shaft that intercouples said proximal and distal movable members;   and actuation means coupled between said movable members and including a first cable set disposed between the proximal and distal movable members so that any movement of the proximal movable member causes a corresponding movement of the distal movable member;   and a follower locking mechanism mounted in the control handle adjacent the open distal end of the control handle, spacedly positioned proximally of the proximal movable member and responsive to motion of the proximal movable member;   at least said proximal movable member comprising a proximal bendable member;   a rotation knob for supporting the proximal bendable member for rotation therewith;   said follower locking mechanism comprising;   a ball member having an outer spherical surface,   an annular rider having an inner concave surface that rides on and conforms to the outer spherical surface of the ball member,   said annular rider constructed and arranged for motion over the outer spherical surface of the ball member in response to motion of said proximal bendable member,   and a locking member at the control handle for fixing the position of the rider on the ball member,   whereby a control of motion of the proximal movable member from the control handle controls motion of the rider on the ball member.   
   
   
       52 . The medical instrument of  claim 51  including a second cable set that couples between a distal end of the proximal movable member and said rider, said second cable set being constructed and arranged to be operated independently of the first cable set. 
   
   
       53 . The medical instrument of  claim 52  wherein said second cable set is adapted to tilt the rider relative to a longitudinal axis of the control handle and in response to a bending of the proximal bendable member. 
   
   
       54 . The medical instrument of  claim 53  wherein the cables of said second set terminate at a fixed position lug at the distal end of the proximal bendable member. 
   
   
       55 . The medical instrument of  claim 54  wherein both of said movable members comprise bendable members that each comprise uni-body members that include discs that define slots therebetween, said first cable set extending through both distal and proximal uni-body members while said second cable set extends through only said proximal uni-body member. 
   
   
       56 . The medical instrument of  claim 52  wherein said follower locking mechanism further includes an anchor ring supported on said rider, said second cable set connected to said anchor ring, said anchor ring to pivot on said ball member in response to bending at said proximal bendable member. 
   
   
       57 . The medical instrument of  claim 56  wherein said anchor ring includes opposed pins and said rotation member comprises a rotation knob that includes a pair of legs that define opposed slots for guiding said pins in the slots. 
   
   
       58 . The medical instrument of  claim 57  wherein the proximal bendable member and the ball member are supported along a common handle axis, and the follower locking mechanism further includes a sleeve on said common axis for supporting the ball member and a retaining ring that, with the rider, captures the anchor ring. 
   
   
       59 . The medical instrument of  claim 52  wherein said ball member is a split ball and said locking member further includes a wedge member that is operable in the locked state to engage the split ball to, in turn, freeze the position of the rider and anchor ring on the ball member. 
   
   
       60 . The medical instrument of  claim 52  wherein said locking member comprises a slide button mounted at said handle and a wedge member responsive to said slide button for locking the position of said follower locking mechanism. 
   
   
       61 . The medical instrument of  claim 60  wherein said ball member comprises a split ball for receiving said wedge member. 
   
   
       62 . The medical instrument of  claim 61  wherein said slide button includes opposed ends that are respectively disposed on opposite sides of the control handle and are manually actuable to either lock or unlock the instrument by depression thereof.