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. A manually rotatable member is arranged adjacent to the control handle for manually rotating the instrument shaft and working member relative to the control handle.

1 . A surgical instrument comprising:
 an elongated instrument shaft having proximal and distal ends;   a working member disposed at the distal end of the instrument shaft; and   a control handle disposed at the proximal end of the instrument shaft;   said working member being coupled to the distal end of said elongated instrument shaft via a distal motion member;   said control handle coupled to the proximal end of said elongated instrument shaft via a proximal bendable member;   actuation means extending 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;   and a manually rotatable member arranged adjacent the control handle for manually rotating the instrument shaft and working member relative to said control handle.   
   
   
       2 - 15 . (canceled) 
   
   
       16 . A surgical instrument comprising:
 an elongated instrument shaft having proximal and distal ends;   a working member disposed at the distal end of the instrument shaft; and   a control handle disposed at the proximal end of the instrument shaft;   said working member being coupled to the distal end of said elongated instrument shaft via a distal motion member;   said control handle coupled to the proximal end of said elongated instrument shaft via a proximal bendable member;   actuation means extending 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;   wherein at least said proximal bendable member comprises a unitary slotted structure having a plurality of discs separated by slots.   
   
   
       17 . (canceled) 
   
   
       18 . The surgical instrument of  claim 16  wherein said proximal bendable member includes a plurality of ribs interconnecting adjacent discs, said ribs being disposed at intervals about the member of less than 90 degrees. 
   
   
       19 . (canceled) 
   
   
       20 . (canceled) 
   
   
       21 . 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 bendable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, a set of bend control cables that are disposed between said bendable members operable so that a bending manipulation of the proximal bendable member controls the bending of the distal bendable member, and a rotation member operable from said control handle, said distal bendable member having a distal end and a proximal end, said proximal bendable member having a distal end and a proximal end, said set of bend control cables each also having a distal end and a proximal end, the distal end of at least one of the bend control cables terminating adjacent the distal end of the distal bendable member, the proximal end of at least one of the bend control cables terminating adjacent the proximal end of the proximal bendable member, and the proximal bendable member is mounted with and for rotation with the rotation member. 
   
   
       22 . The medical instrument of  claim 21  wherein said rotation member comprises a rotation knob that causes a rotation of said proximal bendable member and, in turn, rotation of said instrument shaft, distal bendable member and distal tool. 
   
   
       23 . The medical instrument of  claim 22  wherein the rotation knob has a hollow center portion for receiving at least a portion of the proximal bendable member and an end wall that is rotatably supported relative to the handle in an opening in the handle, and the bend control cables terminate at the end wall of the rotation knob. 
   
   
       24 . The medical instrument of  claim 23  including an adaptor for intercoupling the instrument shaft and the distal end of the proximal bendable member for transitioning the bend control cables from a greater separation distance at the proximal bendable member to a lesser separation distance in the instrument shaft. 
   
   
       25 . The medical instrument of  claim 21  including an actuation cable that extends between the control handle and tool, the actuation cable for operating the tool, the actuation cable extending through the proximal bendable member at the center thereof and the bend control cables disposed through the proximal bendable member in parallel with the actuation cable but disposed toward the outer diameter of the proximal bendable member. 
   
   
       26 . The medical instrument of  claim 21  including an actuation lever pivotally supported from said control handle and an actuator cable intercoupled between said actuation lever and working member. 
   
   
       27 . The medical instrument of  claim 26  including a ratchet and pawl arrangement coupled to said lever, a slider within a housing of said handle, a link for intercoupling the lever and slider and a release button intercoupled to said ratchet. 
   
   
       28 . The medical instrument of  claim 27  including a pair of springs, one supported in said slider and coupled to said link and the other disposed between said slider and the handle housing. 
   
   
       29 . The medical instrument of  claim 21  wherein the bendable members comprise unitary slotted structure including a plurality of discs defining separate and non-contiguous slots. 
   
   
       30 . In a medical instrument having a proximal control handle and a distal tool that are intercoupled by an instrument shaft that is meant to pass internally of an anatomic body, proximal and distal bendable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, and a set of bend control cables disposed between said bendable members, a method of controlling the tool from the handle by means of a rotational control element comprising, mounting the rotational control element at the control handle, commonly supporting the proximal bendable member with the rotational control element, and rotating the rotational control element so as to causes a rotation of the proximal bendable member and, in turn, the instrument shaft and distal tool about a rotational distal tool axis. 
   
   
       31 . The method of  claim 30  wherein said distal bendable member has a distal end and a proximal end, the proximal bendable member has a distal end and a proximal end, and the set of bend control cables also have a distal end and a proximal end, and further including terminating the distal end of at least one of the bend control cables adjacent the distal end of the distal bendable member, terminating the proximal end of at least one of the bend control cables adjacent the proximal end of the proximal bendable member, and maintaining the proximal ends of the bend control cables fixed in position with respect to the proximal end of the proximal bendable member. 
   
   
       32 . The method of  claim 30  wherein the rotation of the rotational control element comprises rotation of a rotation knob to control rotation of the tool about a distal tool axis defined by the rotational arrow R 3 . 
   
   
       33 . The method of  claim 32  including supporting the rotation knob for relative rotation with respect to the control handle. 
   
   
       34 . A surgical instrument comprising: an instrument shaft having proximal and distal ends; a tool disposed from the distal end of the instrument shaft; a control handle disposed from the proximal end of the instrument shaft; said tool being coupled to the distal end of said instrument shaft via a distal bendable member; said control handle coupled to the proximal end of said instrument shaft via a proximal bendable member; whereby movement of said control handle with respect to said instrument shaft via said proximal bendable member causes attendant movement of said tool with respect to said instrument shaft via said distal bendable member; a rotation knob mounted at the control handle so as to rotate relative to the control handle; and means for commonly supporting the proximal bendable member with the rotation knob so that any rotation of the rotation knob concurrently rotates the proximal bendable member to, in turn, control the rotational positioning of the tool about a rotational tool axis. 
   
   
       35 . The surgical instrument of  claim 34  wherein said proximal bendable member has a proximal end and a distal end and said means for commonly supporting the proximal bendable member comprises a hollow pocket in the rotation knob into which is fixedly retained the proximal end of the proximal bendable member. 
   
   
       36 . The surgical instrument of  claim 35  wherein said control handle has an opening into which is arranged the rotation knob for rotation relative to the handle 
   
   
       37 . The surgical instrument of  claim 36  including bend control cables that extend between the proximal and distal bendable members and an adaptor for intercoupling the instrument shaft and the distal end of the proximal bendable member for transitioning the bend control cables from a greater separation distance at the proximal bendable member to a lesser separation distance in the instrument shaft. 
   
   
       38 . The surgical instrument of  claim 34  including bend control cables that extend between the bendable members and an actuation cable that extends between the control handle and tool, the actuation cable for operating the tool, the actuation cable extending through the proximal bendable member at the center thereof and the bend control cables disposed through the proximal bendable member in parallel with the actuation cable but disposed toward the outer diameter of the proximal bendable member. 
   
   
       39 . The surgical instrument of  claim 34  including an actuation lever pivotally supported from said control handle and an actuator cable intercoupled between said actuation lever and tool. 
   
   
       40 . The surgical instrument of  claim 39  including a ratchet and pawl arrangement coupled to said lever, a slider within a housing of said handle, a link for intercoupling the lever and slider and a release button intercoupled to said ratchet. 
   
   
       41 . The surgical instrument of  claim 40  including a pair of springs, one supported in said slider and coupled to said link and the other disposed between said slider and the handle housing. 
   
   
       42 . The surgical instrument of  claim 34  wherein the bendable members each comprise a unitary slotted structure including a plurality of discs defining separate and non-contiguous slots. 
   
   
       43 . In a medical instrument having a proximal control handle and a distal tool that are intercoupled by an instrument shaft that is meant to pass internally of an anatomic body, proximal and distal bendable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, and a set of bend control cables disposed between said bendable members, the distal bendable member having a distal end and a proximal end, the proximal bendable member having a distal end and a proximal end, and the set of bend control cables also having a distal end and a proximal end, a method of controlling the tool from the handle by means of a rotation knob, said method comprising, mounting the rotation knob at the control handle, terminating the distal end of at least one of the bend control cables adjacent the distal end of the distal bendable member, terminating the proximal end of at least one of the bend control cables adjacent the proximal end of the proximal bendable member, and maintaining the proximal ends of the bend control cables fixed in position with respect to the proximal end of the proximal bendable member. 
   
   
       44 . A surgical instrument comprising: an instrument shaft having proximal and distal ends; a tool disposed from the distal end of the instrument shaft; a control handle disposed from the proximal end of the instrument shaft; said tool being coupled to the distal end of said instrument shaft via a distal bendable member; said control handle coupled to the proximal end of said instrument shaft via a proximal bendable member; cabling intercoupling the proximal and distal bendable members; whereby movement of said control handle with respect to said instrument shaft via said proximal bendable member causes attendant movement of said tool with respect to said instrument shaft via said distal bendable member; a rotation knob mounted at the control handle so as to rotate relative to the control handle; said proximal bendable member retained with the rotation knob so that any rotation of the rotation knob concurrently rotates the proximal bendable member to, in turn, control the rotational positioning of the tool; said instrument shaft including an outer shaft member and an inner shaft member that is coaxially disposed in said outer shaft member; said outer shaft member intercoupling said proximal bendable member with said distal bendable member; said inner shaft member intercoupling said proximal bendable member with said distal bendable member; at least said outer shaft member, upon rotation of the rotation knob, concurrently rotating with said rotation knob. 
   
   
       45 . The surgical instrument of  claim 44  wherein both said inner and outer shaft members, upon rotation of the rotation knob, concurrently rotating with said rotation knob. 
   
   
       46 . The surgical instrument of  claim 45  wherein said inner shaft tube is for accommodating an actuator cable for the working member. 
   
   
       47 . The surgical instrument of  claim 45  wherein the outer shaft tube is the outermost shaft tube and is visable from outside the instrument as the outermost shaft tube is rotated by the rotation knob.