Articulating Steerable Clip Applier for Laparoscopic Procedures

Abstract

A long articulating steerable clip applier affixed to a user-operated handle. A surgical jaw assembly is attached to the other end of the clip applier. The clip applier is composed of articulating phalanges that are connected end to end by pivoting links and capable of angulations relative to one another when subjected to a tensile force. Each phalange has opposing s-shaped exterior grooves that form two continuous spiral-shaped channels for holding tension wires once the phalanges are assembled. Multiple tension wires are attached to opposite ends of adjacent phalanges. When each wire is pulled, this tensile force causes the phalanges to pivot at equivalent angles with each other. As each individual phalange pivots by an equivalent angle, the sum of these angles causes the free end of the clip applier to pivot by a large angle or a cascading actuation effect.

1 . An endoscopic surgical tool having a handle and a shaft member coupled to the handle and extending along a shaft axis from a proximal end to a distal end, wherein the distal end of the shaft member is adapted to receive an end effector, comprising:
 A. a linear array of n phalanx sections, where n is an integer greater than  2 , wherein the linear array includes a sequentially aligned proximal phalanx section, n−2 intermediate phalanx sections, and a distal phalanx section, wherein the ith phalanx section, wherein i is greater than or equal to 1 and less than or equal to n, extends along an associated central axis CAi between a proximal end PEi and a distal end DEL and includes:
 a tubular member TMi defining
 a. a central void region CVRi extending along the central axis CAi between the proximal end PEi and the distal end DEi, 
 b. an exterior surface ESi disposed about the central void region CVRi and extending along the central axis CAi from the proximal end PEi to the distal end DEi, 
 
 wherein the n phalanx sections are aligned whereby the central axis CAi of each phalanx section intersects with the central axis of phalanx sections adjacent thereto in the linear array, 
   B. an end effector coupler EEC disposed at the distal end of the distal phalanx section and adapted for coupling the distal end to an end effector,   C. a base coupling assembly BC disposed at the proximal end of the proximal phalanx section and adapted to couple to the proximal end of the proximal phalanx section to the distal end of the shaft member, whereby the shaft axis intersects the central axis of the proximal phalanx section and whereby the proximal phalanx section is movable with respect to the distal end of the shaft member substantially only in rotational motion about a transverse axis TA 0  perpendicular to the central axis of the proximal phalanx section,   D. n−1 phalanx section coupling assemblies PC, wherein each phalanx section coupling assembly is associated with an intermediate phalanx section and wherein the coupling assembly PCi associated with the ith phalanx section couples a distal end of the ith phalanx section to the proximal end of the adjacent i+1th phalanx section whereby the proximal end of the i+1th phalanx section is movable with respect to the distal end of the ith phalanx section substantially only in rotational motion about a transverse axis TAi perpendicular to the central axis of the ith phalanx section, wherein TAi and TA 0  are mutually parallel, and   
       wherein each of the base coupling assembly and the n−1 phalanx coupling assemblies are operative whereby a torque applied to the proximal end of the proximal phalanx section about an axis parallel to transverse axis TA 0 , effects a same-direction angular rotational displacement of each of the ith phalanx sections with respect to the adjacent phalanx sections about the respective transverse axes TAi. 
     
     
         2 . An endoscopic surgical tool according to  claim 1 , wherein the base coupling assembly BC is adapted to detachably couple the proximal end of the proximal phalanx section to the distal end of the shaft member. 
     
     
         3 . An endoscopic surgical tool according to  claim 1 , wherein the end effector coupling assembly EEC is adapted to detachably couple the end effector to the distal end of the distal phalanx section. 
     
     
         4 . An endoscopic surgical tool according to  claim 1 , wherein at least the ith phalanx section coupling assembly Ci includes:
 i. a coupling cam surface CCSi disposed about a cam central axis CCAi affixed to the distal end of the ith phalanx section, wherein the cam central axis CCAi is substantially coaxial with the transverse axis TAi,   ii. a substantially non-stretchable link coupling a point on the coupling cam surface of the ith phalanx section CCSPi with a point EPi+2 on the proximal end of the i+2th phalanx section, wherein point CCSPi and point EPi are disposed in a plane including CAi+1 and perpendicular to the transverse axes TAi and TAi+2 and on opposite sides central axis of the i+1 phalanx section CAi+1.   
     
     
         5 . An endoscopic surgical tool according to  claim 4 , wherein the link of coupling assembly Ci is a cable extending between point CCSPi and point EPi+2. 
     
     
         6 . An endoscopic surgical tool according to  claim 5 , wherein the cable extends in a helical path about the central axis CAi+1 between point CCSPi and point EPi+2. 
     
     
         7 . An endoscope surgical tool according to  claim 6 , wherein the exterior surface ESi includes an open-faced helical channel HCi+1 disposed about the central axis CAi+1, and the cable of coupling assembly Ci extends through the helical channel HCi+1. 
     
     
         8 . An endoscope surgical tool according to  claim 1 , wherein the same-direction angular rotational displacement of each of the ith phalanx sections with respect to the adjacent phalanx sections are equi-angle. 
     
     
         9 . An endoscope surgical tool according to  claim 1 , wherein the tubular members TMi are characterized by the same distance between the proximal end PEi and the distal end Dei. 
     
     
         10 . An endoscope surgical tool according to  claim 1 , wherein at least two of the tubular members TMi are characterized by different distances between their respective proximal ends PEi and distal ends Dei. 
     
     
         11 . An endoscope surgical tool according to  claim 1 , wherein the cam surfaces CCSi are circular segments.