Surgical instruments with improved dexterity for use in minimally invasive surgical procedures

Abstract

A surgical instrument adapted and configured for use in minimally invasive surgical procedures includes a shaft, an end effector and a proximal handle. The longitudinal shaft has proximal and distal end portions, and defines a longitudinal axis of the surgical instrument. The distal end effector is connected to the distal end portion of the shaft, and is adapted and configured for performing a surgical task. The proximal handle portion is operably connected to the proximal end portion of the longitudinal shaft and has an actuatable portion operably connected to the end effector to result in movement of the end effector. The distal end portion of the shaft can be laterally offset from the longitudinal axis of the shaft and/or have one or more bends or curves formed therein. The proximal portion of the shaft can include at least one bend to allow for comfortable positioning of a surgeon's hands.

1 . A surgical instrument adapted and configured for use in minimally invasive surgical procedures, the surgical instrument comprising:
 (a) a shaft having proximal and distal end portions, the shaft defining a longitudinal axis of the surgical instrument;   (b) an end effector operably connected to the distal end portion of the shaft, adapted and configured for performing a surgical task; and   (c) a handle portion connected to the proximal end portion of the shaft, having an actuatable portion operably connected to the end effector to result in movement of the end effector when actuated,   (d) wherein the distal end portion of the shaft is laterally offset from the longitudinal axis of the shaft.   
     
     
         2 . The surgical instrument of  claim 1 , wherein the distal end portion of the shaft is substantially parallel to the proximal end portion of the shaft. 
     
     
         3 . The surgical instrument of  claim 1 , wherein the distal end portion of the shaft includes an arcuate portion that deviates from the longitudinal axis of the shaft. 
     
     
         4 . The surgical instrument of  claim 3 , wherein the arcuate portion curves in a plane that is substantially orthogonal, with respect to the longitudinal axis of the shaft, to a plane in which the lateral jog is formed. 
     
     
         5 . A surgical instrument adapted and configured for use in minimally invasive surgical procedures, the surgical instrument comprising:
 (a) a shaft having proximal and distal end portions;   (b) an end effector connected to the distal end portion of the shaft, adapted and configured for performing a surgical task; and   (c) a handle portion connected to the proximal end portion of the longitudinal shaft, having an actuatable portion operably connected to the end effector to result in movement of the end effector when actuated,   (d) wherein the handle portion of the surgical instrument is arranged at an obtuse angle with respect to the longitudinal axis of the proximal longitudinal end of the shaft of the surgical instrument.   
     
     
         6 . The surgical instrument of  claim 5 , wherein the end effector is one of a surgical stapler, dissector, grasper and retractor. 
     
     
         7 . A surgical instrument adapted and configured for use in minimally invasive surgical procedures, the surgical instrument comprising:
 (a) a shaft having proximal and distal end portions;   (b) an end effector connected to the distal end portion of the shaft, adapted and configured for performing a surgical task; and   (c) a handle portion connected to the proximal end portion of the longitudinal shaft, having an actuatable portion operably connected to the end effector to result in movement of the end effector when actuated,   (d) wherein a bend is formed in the shaft, such that the proximal end portion of the surgical instrument is arranged at an acute angle with respect to the distal end portion of the surgical instrument, offsetting the handle from the longitudinal axis of the distal portion of the shaft.   
     
     
         8 . A surgical instrument adapted and configured for use in minimally invasive surgical procedures, the surgical instrument comprising:
 (a) a longitudinal shaft having proximal and distal end portions;   (b) a distal end effector operably connected to the distal end portion of the shaft, adapted and configured for performing a surgical task; and   (c) a proximal handle portion connected to the proximal end portion of the longitudinal shaft, having an actuatable portion operably connected to the end effector to result in movement of the end effector when actuated,   (d) wherein the handle portion is rotatably connected to the proximal end portion of the shaft; and   (e) the end effector is rotatably connected to the distal end portion of the shaft, the handle portion and the end effector being mutually connected such that relative rotation of the handle portion with respect to the shaft causes relative rotation of the end effector with respect to the shaft.   
     
     
         9 . The surgical instrument of  claim 8 , wherein a flexible connecting member is provided in the shaft to transfer a rotational force from the handle portion to the end effector. 
     
     
         10 . A method of performing a laparoscopic cholecystectomy, comprising the steps of:
 a) inserting a single access port through the abdominal wall of a patient;   b) introducing a scope through the access port;   c) inserting a surgical grasper through the access port;   d) lifting the gall bladder with the surgical grasper;   e) inserting a dissector through the access port;   f) dissecting the cystic duct and artery with the dissector;   g) inserting a clip applier and surgical scissor through the access port;   h) terminating the cystic duct and artery with the clip applier;   i) cutting the cystic duct and artery with a surgical scissor;   j) inserting an energy device through the access port;   k) dissecting the gall bladder from the liver bed with the energy device;   l) introducing a specimen bag through the access port;   m) removing the gallbladder from the abdominal cavity with the specimen bag;   n) removing the access port; and   o) closing the incision with a suitable closure.   
     
     
         11 . A surgical instrument adapted and configured for use in minimally invasive surgical procedures, the surgical instrument comprising:
 (a) a shaft having proximal and distal end portions, the shaft defining a longitudinal axis of the surgical instrument;   (b) an end effector operably connected to the distal end portion of the shaft, adapted and configured for performing a surgical task; and   (c) handle portion connected to the proximal end portion of the shaft, having an actuatable portion operably connected to the end effector to result in movement of the end effector when actuated,   (d) wherein the distal end portion of the shaft is arcuately offset from the longitudinal axis of the shaft.   
     
     
         12 . The surgical instrument of  claim 11 , wherein the distal end portion of the shaft is additionally laterally offset from the proximal end portion thereof. 
     
     
         13 . The surgical instrument of  claim 12 , wherein the laterally offset distal end portion is substantially parallel to the proximal end portion of the shaft. 
     
     
         14 . The surgical instrument of  claim 12 , wherein the arcuate offset and lateral offset are formed in mutually orthogonal planes, with respect to a longitudinal axis of the shaft. 
     
     
         15 . The surgical instrument of  claim 12 , wherein the arcuate offset and lateral offset are formed in mutually parallel planes, with respect to a longitudinal axis of the shaft. 
     
     
         16 . The surgical instrument of  claim 12 , wherein the end effector and actuatable portion of the handle are mutually operably connect by an actuating element. 
     
     
         17 . The surgical instrument of  claim 16 , wherein the actuating element is formed of a flexible material. 
     
     
         18 . The surgical instrument of  claim 16 , wherein the actuating element is a composite element formed of at least two longitudinally coupled sections. 
     
     
         19 . The surgical instrument of  claim 16 , wherein the actuating element is formed of a coiled material. 
     
     
         20 . A surgical instrument for laparoscopic procedures, the surgical instrument comprising:
 a) a handle portion;   b) an elongated shaft extending from the handle portion, the shaft having one or more bends or curves formed therein;   c) an actuating member extending from the handle through the elongated shaft, the actuating member including a plurality of axially-connected shaft portions including rigid and flexible portions; and   d) an effector provided on a distal end of the elongated shaft, operatively connected to the actuating member for performing a surgical task.   
     
     
         21 . The surgical instrument of  claim 20 , wherein the one or more bends or curves includes a bend in a proximal portion of the shaft. 
     
     
         22 . The surgical instrument of  claim 21 , wherein the bend is between about 30 and 60 degrees. 
     
     
         23 . The surgical instrument of  claim 20 , wherein the one or more bends or curves includes an arcuate curve in the distal portion of the shaft. 
     
     
         24 . The surgical instrument of  claim 20 , wherein the one or more bends or curves are provided in the shaft such that the position of the handle portion, when the instrument is in a working position, inserted through a surgical access device, is such that it approximates the position of a handle of a surgical instrument used in an open surgical procedure. 
     
     
         25 . The surgical instrument of  claim 24 , wherein the one or more bends or curves are provided such that when a plurality of instruments are inserted through a single access device, a portion of the shaft of the surgical instruments passing through the surgical access device are mutually substantially parallel, and a proximal end portion of the surgical instruments extend away from a longitudinal axis of the respective surgical instrument.