Surgical instrument

Abstract

A surgical instrument includes a tubular stem section which extends from a handle. A tubular articulated section connects a surgical instrument with the stem section. An actuator assembly is connected with the handle and is operable to bend the articulated section to change the orientation of an instrument on an outer end portion of the articulated section relative to body tissue. The instrument on the outer end of the articulated section may be a rotatable cutting tool which is driven by a tubular drive element having a flexible section which extends through the articulated section. The articulated section is bent or flexed by a plurality of flexible elongated elements (wires). In one embodiment of the invention, a pair of elongated elements are provided to flex the articulated section in opposite directions. In another embodiment of the invention, four flexible elongated elements are provided to flex the articulated section in any one of four directions.

1. A surgical instrument comprising a stem section extending from a handle, a cutting tool, said cutting tool including a rotatable cutter a hollow articulated section connected with said cutting tool and said stem section, a rotatable drive shaft connected with said cutter and disposed in and extending axially through said stem section and said articulated section, said drive shaft having a flexible portion disposed in said articulated section, and actuator means connected with said handle for bending said articulated section and said flexible portion of said drive shaft to change the orientation of said cutter relative to time from a first orientation to a second orientation, said actuator means including first and second elongated elements which extend through said stem section and articulated section and are connected with said cutting tool, said elongated elements being disposed between an outer side surface of said flexible portion of said drive shaft and an inner side of said articulated section, said actuator means including means for pulling on one of said elongated dements to bend said articulated section and said flexible portion or said drive shaft to change the orientation of said cutter from the first orientation to the second orientation, said drive shaft being rotatable relative to said articulated section to rotate said cutter when said cutter is in the first orientation and when said cutter is in the second orientation;
 said surgical instrument further including passage means extending axially through said drive shaft for conducting tissue from a location adjacent to said cutter through said articulated section and said stem section toward the handle.  
 
     
     
       2. A surgical instrument comprising a stem section extending from a handle, a cutting tool, said cutting tool including a rotatable cutter, a hollow articulated station connected with said cutting tool and said stem section, a rotatable drive shaft connected with said cutter and disposed in and extending axially through said stem section and said articulated section, said drive shaft having a flexible portion disposed in said articulated section, and actuator means connected with said handle for bending said articulated section and said flexible portion of said drive shaft to change the orientation or said cutter relative to time from a first orientation to a second orientation, said actuator means including first and second elongated elements which extend through said stem section and articulated section and are connected with said cutting tool, said elongated elements being disposed between an outer side surface of said flexible portion of said drive shaft and in inner side of said articulated section, said actuator means including means for pulling on one of said elongated elements to bend said articulated section and said flexible portion of said drive shaft to change the orientation of said cutter from the first orientation to the second orientation, said drive shaft being rotatable relative to said articulated section to rotate said cutter when said cutter is in the first orientation and when said cutter is in the second orientation;
 said surgical instrument further including passage means extending through said drive shaft for conducting irrigating fluid through said drive shaft from said handle to said cutter.  
 
     
     
       3. A surgical instrument comprising a hollow rigid stem section extending from a handle, a cutting tool, said cutting tool including a rotatable cutter, a hollow articulated section connected with said cutting tool and said stem section, a rotatable drive shaft connected with said cutter and disposed in and extending axially through said stem section and said articulated section, said drive shaft including a rigid section disposed in said stem section and a flexible section disposed in said articulated section, and actuator means connected with said handle for bending said articulated section and said flexible section of said drive shaft to change, the orientation of said cutter relative to tissue from a first orientation to a second orientation, said drive shaft being rotatable relative to said articulated section when said cutter is in the first orientation and when said cutter is in the second orientation, said actuator means extending through substantially the entire length of said articulated section, said cutting tool being prevented from moving in an axial direction relative to said articulated section;
 said surgical instrument further including passage means extending axially through said drive shaft for conducting tissue from a location adjacent to said cutter through said articulated section and said stem section toward the handle.  
 
     
     
       4. A surgical instrument comprising a hollow rigid stem section extending from a handle, a cutting tool, said cutting tool including a rotatable cutter a hollow articulated section connected with said cutting tool and said stem section, a rotatable drive shaft connected with said cutter and disposed in and extending axially through said stem section and said articulated section, said drive shaft including a rigid section disposed in said stem section and a flexible section disposed in said articulated section and actuator means connected with said handle for bending said articulated section and said flexible section of said drive shaft to change the orientation of said cutter relative to tissue from a first orientation to a second orientation, said drive shaft being rotatable relative to said articulated section when said cutter is in the first orientation and when said cutter is in the second orientation;
 wherein said actuator means includes first and second elongated elements which extend through said stem section and articulated section and are connected with said cutting tool, said elongated elements being disposed between an outer side surface of said flexible section of said drive shaft and an inner side of said articulated section, said actuator means including means for pulling on said first elongated element to bend said articulated section and the flexible section of the drive shaft in a first direction, said actuator means including means for pulling on said second elongated element to bend said articulated section and said flexible section of said drive shaft in a second direction opposite to said first direction.  
 
     
     
       5. A surgical instrument comprising a hollow rigid stem section extending from a handle, a cutting tool, said cutting tool including a rotatable cutter, a hollow articulated section connected with said cutting tool and said stem section, a rotatable drive shaft connected with said cuter and disposed in and extending axially through said stem section and said articulated section, said drive shaft including a rigid section disposed in said stem section and a flexible section disposed in said articulated section, and actuator means connected with said handle for bending said articulated section and said flexible section of said drive shaft to change the orientation of said cutter relative to tissue from a first orientation to a second orientation, said drive shaft being rotatable relative to said articulated section when said cutter is in the first orientation and when said cutter is in the second orientation, said actuator means extending through substantially the entire length of said articulated section, said cutting tool being prevented from moving in an axial direction relative to said articulated section;
 said surgical instrument further including passage means extending axially through said drive shaft for conducting irrigating fluid from said handle to said cutter.  
 
     
     
       6. A surgical instrument comprising a stem section extending from a handle, a movable member, a hollow articulated section connected with said movable member and said stem section, a drive shaft connected with said movable member and disposed in and extending axially through said stem section and said articulated section, said drive shaft having a flexible portion disposed in said articulated section and actuator means a connected with said handle for bending said articulated section and said flexible portion of said drive shaft to change the orientation of said movable member relative to tissue from a first orientation to a second orientation, said actuator means including first and second elongated element which extend through said stem section and substantially the entire length of said articulated section and are connected directly with said movable member, said actuator means including means for pulling on one of said elongated elements to bend said articulated section and said flexible portion of said drive shaft to change the orientation of said movable member from the first orientation to the second orientation, said drive shaft being movable relative to said articulated section to move said movable member when said movable member is in the first orientation and when said movable member is in the second orientation;
 said surgical instrument further including passage means extending axially through said drive shaft for conducting tissue from a location adjacent to said movable member through said articulated section and said stem section toward the handle.  
 
     
     
       7. A surgical instrument comprising a stem section extending from a handle, a movable member, a hollow articulated section connected with said movable member and said stem section, a drive shaft connected with said movable member and disposed in and extending axially through said stem section and said articulated section, said drive shaft having a flexible portion disposed in said articulated section, and actuator means connected with said handle for bending said articulated section and said flexible portion of said drive shaft to change the orientation of said movable member relative to tissue from a first orientation to a second orientation, said actuator moms including first and second elongated elements which extend through said stem section and substantially the entire length of said articulated section and are connected directly with said movable member, said actuator means including means for pulling on one of said elongated elements to bend said articulated section and said flexible portion of said drive shaft to change the orientation of said movable member from the first orientation to the second orientation, said drive shaft being movable relative to said articulated section to move said movable member when said movable member is in the first orientation and when said movable member is in the second orientation;
 said surgical instrument further including passage means extending through said drive shaft for conducting irrigating fluid through said drive shaft from said handle to said movable member.  
 
     
     
       8. A surgical instrument comprising a handle, a stem section extending from add handle, means for acting on tissue including a movable member, a hollow articulated section connected with said movable member and said stem section, means connected with said movable member for moving said movable member relative to said articulated section, said mesas being disposed in and extending axially through said stem section and said articulated section, said means having a flexible portion disposed in said articulated section, said actuator means connected with said handle for bending said articulated section and said flexible portion of acid means for moving said movable member to change the orientation of said movable member relative to tissue from a first orientation to a second orientation, said actuator means including a least one elongate element which extends through said stem section and articulated section and is connected with said movable member, said means for moving said movable member being movable relative to said articulated section to move said movable member relative to said articulated section when said movable member is in the first orientation and when said movable member is in the second orientation;
 said surgical instrument further including passage means extending axially through said means for moving said movable member for conducting tissue from a location adjacent to said movable member through said articulated section and said stem section toward said handle.    
     
     
       9. A surgical instrument comprising a handle, a stem section extending from said handle, means for acting on tissue including a movable member, a hollow articulated section connected with said movable member and said stem section, means connected with said movable member for moving said movable member relative to said articulated section, odd means being disposed in and extending axially through said stem section and said articulated section, said means having a flexible portion disposed in said articulated section, and actuator means connected with said handle for bending said articulated section and add flexible portion of said means for moving said movable member to change the orientation of said movable member relative to tissue from a first orientation to a second orientation, said actuator means including a least one elongate element which extends through said stem section and articulated section and is connected with said movable member, said means for moving said movable member being movable relative to said articulated section to move said movable member relative to said articulated section when said movable member is in the first orientation and when said movable member is in the second orientation;
 said surgical instrument further including passage means extending through said means for moving said movable member for conducting irrigating fluid from said handle to said movable member.    
     
     
       10. A surgical instrument comprising:
   a handle;        a stem section extending from said handle;        means for acting on tissue including a movable member;        a hollow articulated section connected with said movable member and said stem section;        means connected to a portion of said movable member for moving said portion relative to said articulated section, said means being disposed in and extending axially through said stem section and said articulated section, said means having a flexible portion disposed in said articulated section; and        actuator means connected to said handle for bending said articulated section and said flexible portion of said means for moving said portion of said movable member to change the orientation of said movable member relative to tissue from a first orientation to a second orientation, said actuator means including at least one elongated element which extends through said stem section and substantially the entire length of said articulated section and is connected directly to said movable member;        said means for moving said portion of said movable member being movable relative to said articulated section when said movable member is in the first orientation and when said movable member is in the second orientation;        said surgical instrument further including passage means for conducting tissue from a location adjacent to said movable member to said handle, said passage means extending axially from said movable member through said articulated section and said stem section to said handle, said passage means extending through said means for moving said portion of said movable member.      
     
     
       11. A surgical instrument comprising:
   a handle;        a stem section extending from said handle;        means for acting on tissue including a movable member;        a hollow articulated section connected to said movable member and said stem section;        means connected to a portion of said movable member for moving said portion relative to said articulated section, said means being disposed in and extending axially through said stem section and said articulated section, said means having a flexible portion disposed in said articulated section; and        actuator means connected to said handle for bending said articulated section and said flexible portion of said means for moving said portion of said movable member to change the orientation of said movable member relative to tissue from a first orientation to a second orientation, said actuator means including at least one elongated element which extends through said stem section and substantially the entire length of said articulated section and is connected directly to said movable member;        said means for moving said portion of said movable member being movable relative to said articulated section to move said movable member relative to said articulated section when said movable member is in the first orientation and when said movable member is in the second orientation;        said surgical instrument further including passage means for conducting irrigating fluid from said handle to said movable member, said passage means extending axially from said handle through said articulated section and said stem section to said movable member, said passage means extending through said means for moving said portion of said movable member.