Articulating surgical instruments and methods of deploying the same

Abstract

A surgical instrument comprises a steering mechanism. The steering mechanism comprises a handle at a proximal end of the surgical instrument. The handle includes a plurality of controls for controlling a movement of the surgical instrument. The steering mechanism also comprises a hub that rotatably mates with the handle and a housing positioned about the hub. The handle, the housing, and the hub communicate with each other to provide at least a first degree of freedom and a second degree of freedom. An articulation region is at a distal end of the surgical instrument. A movement of the steering mechanism handle in one and only one of the first or second degrees of freedom relative to at least one of the housing or the hub translates to a movement of the articulation region in a single plane of motion.

What is claimed is: 
     
         1 . (canceled) 
     
     
         2 . A surgical instrument, comprising:
 a steering mechanism, comprising:
 a handle at a proximal end of the surgical instrument; and 
 a hub that rotatably mates with the handle; 
   a housing that rotatably mates with the hub, wherein the handle, the housing, and the hub communicate with each other to provide at least a first degree of freedom and a second degree of freedom;   an articulation region at a distal end of the surgical instrument;   a tool shaft coupling the handle and the articulation region;   a trigger assembly;   a translating assembly that is translated in response to movement of the trigger assembly;   a ratchet mechanism that maintains the translating assembly in a series of linear positions; and   an activation element coupled to the translating assembly that extends through the tool shaft and through the articulation region, the activation element being translated relative to the articulation region in response to the translation of the translating assembly,   wherein a movement of the handle relative to the housing in the first degree of freedom results in a movement of the articulation region in a first plane of motion; and   wherein a movement of the handle relative to the hub in the second degree of freedom results in a movement of the articulation region in a second plane of motion, and   wherein elements of the handle, the hub, and the housing are arranged as a U-joint, the U-joint providing the first and second degrees of freedom.   
     
     
         3 . The surgical instrument of  claim 2 , wherein the trigger assembly, the gearing mechanism, the translating assembly, and the ratchet mechanism are positioned at the handle. 
     
     
         4 . The surgical instrument of  claim 2 , wherein the first plane of motion is orthogonal to the second plane of motion. 
     
     
         5 . The surgical instrument of  claim 2 , wherein the U-joint further comprises a first hinge along a first axis, the first hinge providing the first degree of freedom between the handle and the housing about the first axis, a region of the housing and a region of the hub in communication with each other at the first hinge. 
     
     
         6 . The surgical instrument of  claim 5 , wherein the U-joint further comprises a second hinge along a second axis orthogonal to the first axis, the second hinge providing the second degree of freedom between the hub and the handle about the second axis. 
     
     
         7 . The surgical instrument of  claim 2 , further comprising a plurality of steering cables coupled between the steering mechanism and the articulation region, wherein articulation of the handle relative to the housing advances and retracts the plurality of steering cables, which move the articulation region in the first plane of motion, in the second plane of motion or in the first and second planes of motion. 
     
     
         8 . The surgical instrument of  claim 7 , wherein the plurality of steering cables comprises first and second steering cables that extend from the steering mechanism to the articulation region, the first and second steering cables constructed and arranged to move the articulation region in the first plane of motion when the handle articulates in the first degree of freedom relative to the housing. 
     
     
         9 . The surgical instrument of  claim 8 ,
 wherein the articulation region moves in the first plane of motion in response to a movement of at least one of the first or second steering cables in an axial direction between the handle and the articulation region, and   wherein the movement of the at least one of the first or second steering cables in the axial direction is in response to a movement by the handle relative to the housing at the first degree of freedom.   
     
     
         10 . The surgical instrument of  claim 8 , wherein the hub includes first and second cable fastening locations that couple proximal ends of the first and second steering cables to the hub. 
     
     
         11 . The surgical instrument of  claim 8 , further comprising third and fourth steering cables that extend from the steering mechanism to the articulation region, the third and fourth steering cables constructed and arranged to move the articulation region in the second plane of motion when the handle articulates in the second degree of freedom relative to the housing. 
     
     
         12 . The surgical instrument of  claim 11 ,
 wherein the articulation region moves in the second plane of motion in response to a movement of at least one of the third or fourth steering cables in an axial direction between the handle and the articulation region, and   wherein the movement of the at least one of the third or fourth steering cables in the axial direction is in response to a movement by the handle relative to the hub in the second degree of freedom.   
     
     
         13 . The surgical instrument of  claim 11 , wherein the hub comprises first and second cable pass-through holes and the handle comprises first and second fastening locations, wherein the third and fourth steering cables extend through the first and second cable pass-through holes, respectively, and wherein proximal ends of the third and fourth steering cables are coupled to the handle. 
     
     
         14 . The surgical instrument of  claim 2 , further comprising an end effector positioned at a distal end of the articulation region, and coupled to the activation element. 
     
     
         15 . The surgical instrument of  claim 14 , wherein the handle includes the trigger assembly, the translating assembly, and the ratchet mechanism that operate to incrementally ratchet a movement of the end effector. 
     
     
         16 . The surgical instrument of  claim 14 , wherein the end effector comprises a housing and at least one tool. 
     
     
         17 . The surgical instrument of  claim 16 , wherein the at least one tool comprises at least one of: a grasper; a scissor; a cutter; a claw; or a knife. 
     
     
         18 . The surgical instrument of  claim 16 , wherein the at least one tool comprises at least one of: an ablator; a drug delivery apparatus; a radiation source; an EKG electrode; a pressure sensor; a blood sensor; a camera; a magnet; a heating element; an energy delivery element; or a cryogenic element. 
     
     
         19 . The surgical instrument of  claim 14 , further comprising a support element that extends along at least a portion of the instrument, through a central working channel of the articulation region, and terminates at the end effector housing. 
     
     
         20 . The surgical instrument of  claim 19 , wherein the activation element is positioned in a lumen of the support element. 
     
     
         21 . The surgical instrument of  claim 19 , further comprising a rotation knob positioned at the handle, the rotation knob operably coupled to the support element, the support element operably coupled to the end effector so that rotation of the rotation knob causes axial rotation of the support element about a longitudinal axis, in turn causing axial rotation of the end effector about the longitudinal axis. 
     
     
         22 . The surgical instrument of  claim 2 , wherein the trigger assembly comprises a trigger and a spring which is biased to maintain the trigger in a position. 
     
     
         23 . The surgical instrument of  claim 22 , wherein the trigger comprises an un-pulled position, such as in a position in which a tool coupled to the articulation region is in an open or un-activated position. 
     
     
         24 . The surgical instrument of  claim 22 , wherein the ratchet mechanism is constructed and arranged to resist the force of the trigger spring. 
     
     
         25 . The surgical instrument of  claim 2 , wherein the ratchet mechanism is constructed and arranged to be in a disengaged position to release the translating assembly, or to be locked in an engaged position such that the trigger controls the translating assembly. 
     
     
         26 . The surgical instrument of  claim 2 , wherein the handle further includes a ratchet selector that activates and de-activates the ratchet mechanism. 
     
     
         27 . The surgical instrument of  claim 2 , further comprising a gearing mechanism coupled between the trigger assembly and the translating assembly, and wherein the translating assembly is translated in response to movement of the trigger assembly via the gearing mechanism. 
     
     
         28 . The surgical instrument of  claim 27 , wherein the translating assembly comprises a linear gear that mates with the gearing mechanism to drive the translating assembly proximally and distally within the handle. 
     
     
         29 . The surgical instrument of  claim 2 , wherein the ratchet mechanism comprises a ratchet lock, a release ramp, and a ratchet selector configured to position the ratchet lock. 
     
     
         30 . The surgical instrument of  claim 29 , wherein the translating assembly comprises a plurality of teeth, wherein in a first, engaged position, the ratchet lock engages the teeth, and wherein in a second, disengaged position, the release ramp slides beneath the ratchet lock disengaging the ratchet teeth, allowing the translating assembly to move freely. 
     
     
         31 . The surgical instrument of  claim 29 , wherein the ratchet selector includes a first securing projection and a second securing projection, wherein the handle includes a housing comprising a first notch and a second notch that frictionally engages with the first and second securing projection, respectively.