Ethicon Endo-Surgery, Inc.

Michel A Paul

Edward A Rhad

Gregory D Bishop

Narinderjit S Sambi

Jorge N Gutierrez

John A Hibner

Sean P Conlon

Lynetta J Freeman

Thomas J Sierocuk

Livyn O Okorocha

Francis J Kramer

A surgical method for creating an operative space during an endoscopic surgical procedure is disclosed. The method incorporates the use of an elongate instrument with an atraumatic tip for facilitating manual dissection of layers of tissues by advancing the instrument between the layers desired to be dissected. As the manual dissection is performed, the space between the dissected layers is enhanced by concurrently insufflating the dissected space as the instrument is advanced. Concurrently insufflating while dissecting eliminates the need to use a balloon dissector for creating the operative space. An improved surgical instrument particularly adapted to carry out this procedure is also disclosed. The improved surgical instrument is an optical obturator incorporating a contrasting imaging element displayed on the transparent tip of the obturator. The contrasting imaging element helps the surgeon to orient the positioning of the instrument relative to adjacent layers desired to be dissected for the creation of the operative space.

Surgical dissector and method for its use

Various mechanisms, and a method of operating them, are provided for use in a surgical instrument. A shaft and an engaged lost motion operating knob are provided for rotation relative to a handle portion. A latch system prevents rotation of the shaft unless the shaft is rotated by means of the knob. A cartridge is provided for rotation at the distal end of the shaft. Engaging structures are provided for preventing rotation of the cartridge relative to the shaft when axial forces are applied to the cartridge. A loading tool is provided for engaging the cartridge to install the cartridge on the instrument. The cartridge includes a washer for engaging a carrier on which the cartridge is mounted so as to prevent rotation of the washer. The washer is adapted to engage a fastener advancing member in a first angular orientation and is disengaged when the cartridge is rotated to establish a second relative angular orientation. In the first angular orientation, the fastener advancing member is restrained against longitudinal movement to assist in installation of the cartridge onto the instrument. The distal end of the instrument can be articulated, and a helical gear operator is provided for effecting the articulation. The helical gear pitch decreases in a direction such that the mechanical advantage is increased as the articulation angle increases. A trigger actuating system includes a trigger lever with a cam channel, a pin in the cam channel, and a link connected at one end to the pin and at the other end to a reciprocatable driver. A frame is provided with a guide channel for guiding an end of the pin. The trigger lever is pivotally mounted to the frame and biased to a normally unactuated position.

Surgical instrument and method

Various mechanisms, and a method of operating them, are provided for use in a surgical instrument. A shaft and an engaged lost motion operating knob are provided for rotation relative to a handle portion. A latch system prevents rotation of the shaft unless the shaft is rotated by means of the knob. A cartridge is provided for rotation at the distal end of the shaft. Engaging structures are provided for preventing rotation of the cartridge relative to the shaft when axial forces are applied to the cartridge. A loading tool is provided for engaging the cartridge to install the cartridge on the instrument. The cartridge includes a washer for engaging a carrier on which the cartridge is mounted so as to prevent rotation of the washer. The washer is adapted to engage a fastener advancing member in a first angular orientation and is disengaged when the cartridge is rotated to establish a second relative angular orientation. In the first angular orientation, the fastener advancing member is restrained against longitudinal movement to assist in installation of the cartridge onto the instrument. The distal end of the instrument can be articulated, and a helical gear operator is provided for effecting the articulation. The helical gear pitch decreases in a direction such that the mechanical advantage is increased as the articulation angle increases.

Method for operating a surgical instrument

Various mechanisms are provided for use in a surgical instrument. A shaft and an engaged lost motion operating knob are provided for rotation relative to a handle portion. A latch system prevents rotation of the shaft unless the shaft is rotated by the knob. A cartridge is provided for rotation at the distal end of the shaft. Engaging structures are provided for preventing rotation of the cartridge relative to the shaft when axial forces are applied to the cartridge. A loading tool is provided for engaging the cartridge to install the cartridge on the instrument. The cartridge includes a washer for engaging a carrier on which the cartridge is mounted so as to prevent rotation of the washer. The washer is adapted to engage a fastener advancing member in a first angular orientation and is disengaged when the cartridge is rotated to establish a second relative angular orientation. In the first angular orientation, the fastener advancing member is restrained against longitudinal movement to assist in installation of the cartridge onto the instrument. The distal end of the instrument can be articulated, and a helical gear operator is provided for effecting the articulation.

Surgical instrument

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Naperville, IL, United States of America

Michel A Paul