摘要:
The methods and devices of the invention include an encoder, an endoscopic robotic instrument, and an encoder/robotic instrument interface. A preferred embodiment of the encoder has a chest/shoulder plate provided with telescoping tubes and joints. Each joint is provided with a direct drive potentiometer to monitor movement and provide a corresponding signal. The chest plate is preferably adaptable to a large range of human chest sizes and the telescopic segments are strapped to the arms of the practitioner at the elbows. A pistol grip is provided at the wrist end of the telescopic segments. According to the presently preferred embodiment, the encoder encodes flexion and rotation at the shoulder, elbow and wrist of each arm in addition to gripping at each hand. The encoding device is coupled to a circuit which operates a servo system. The servo system includes a series of servo motors. A series of pulleys corresponding to the number of servo motors are arranged in a housing. The robotic instrument preferably comprises two arms mounted at the distal end of a multi-lumen tube. Each arm has rotational and flexional joints corresponding to the shoulder, elbow, and wrist of the practitioner. Tendons are coupled to the pulleys of the servo motors and are fed through the multi-lumen tube to the joints of the two arms.
摘要:
An endoscopic or laparoscopic biopsy forceps instrument is provided which includes a flexible tubular member having proximal and distal ends, a biopsy jaw assembly at the distal end of the tubular member, an actuation assembly to operate the jaw assembly between open and closed positions, and a control assembly to deflect the biopsy jaw assembly relative to a lumen through which the instrument extends and to rotate the jaw assembly about the longitudinal axis of the instrument.
摘要:
Surgical clips, which are particularly useful in the transoral invagination and fundoplication of the stomach to the esophagus, and methods of applying the surgical clips to living tissue are disclosed. The clips include first and second arms joined by a bridge to form a substantially U-shape, and which are provided with a first structure adapted to prevent a movement of the clip in a direction perpendicular to a longitudinal axis of the clip after the clip is applied to tissue. In addition, the clips preferably also include a second structure adapted to prevent rotation of the clip about the longitudinal axis of the clip after the clip is applied to tissue.
摘要:
A flexible endoscopic clip applier includes a flexible coil with a manual actuator coupled to one end and a jaw assembly coupled to the other end. A store of clips is arranged adjacent to the jaw assembly and a clip pusher is arranged adjacent to the store of clips. The actuator includes a lever for opening and closing the jaws, a knob for rotating the jaw assembly, and a crank for dispensing clips. The knob and the lever are coupled to a single control member which extends through the coil to a joiner where it is joined to a pair of pull wires coupled to the jaws. The crank is coupled to a second control member which is threaded along a distal portion. The threaded portion engages a threaded member near the pusher and is coupled to the pusher such that rotation of the threaded control member by the crank causes the pusher to be moved distally.
摘要:
A flexible endoscopic clip applier includes a flexible coil, a manual actuator coupled to one end and a jaw assembly coupled to the other. A store of clips is arranged adjacent to the jaw assembly and a clip pusher adjacent to the store of clips. The actuator includes a lever for opening and closing the jaws, a knob for rotating the jaw assembly, and a crank for dispensing clips. The knob and lever are coupled to a single control member which extends through the coil to a joiner where it is joined to a pair of pull wires coupled to the jaws. The crank is coupled to a second control member which is threaded along a portion. The threaded portion engages a threaded member near the pusher such that rotation of the second control member by the crank causes the pusher to be moved distally.
摘要:
A surgical clip has a base portion and two generally parallel, spaced arms extending from the base portion and defining an opening therebetween. The arms terminate distally in fingers which are of reduced width and thickness relative to the arms and which are adapted to be bent towards and past each other. A transition section from each arm to the finger provides curved structures which extending away from each other and providing a wider mouth for the opening between the arms. The arms also have a proximal section with an undercut which helps in flexure of the arms. The base is an extended structure having a rounded proximal end with outwardly extending shoulders which are arranged to be engaged by the curved structures of the mouth of another clip.
摘要:
An endoscopic needle device includes an inner fluid conduit, an outer sheath extending over the length of the conduit, a longitudinally stiff wire extending through the conduit, and a needle fixedly attached to the distal end of the conduit. The distal end of the wire is coupled to one or both of the needle and the distal end of the conduit. The needle includes a proximal opening such that the hollow of the needle is in fluid communication with a lumen of conduit. A proximal handle includes a stationary member and a movable member longitudinally movable relative to the stationary member. The proximal end of the outer sheath is coupled to the stationary member, and the stationary member includes structure to mount the handle to a port of an endoscope. The movable member includes a passageway, and the proximal end of the conduit is coupled to the distal end of the movable member, and a port is provided at the proximal end of the movable member. A syringe may be coupled to the port and operated to inject a fluid which travels through the passageway, the lumen of the conduit, and the needle. In addition, the proximal end of the wire is coupled to the movable member. The handle assembly also includes a knob rotatably coupled to the stationary member, wherein rotation of the knob results in reciprocal movement of the movable member relative to the stationary, and consequently the needle relative to the distal end of the outer sheath.
摘要:
An apparatus for the transoral invagination and fundoplication of the stomach to the esophagus includes a clip applier having sharp toothed jaws for grasping and damaging the fundus prior to applying the clip. The clip applier has an overall diameter of less than 7 mm. The clip applier jaws are coupled to a pull wire via a linkage which increases the mechanical advantage and thus permits greater grasping force. A plurality of clip designs are also provided.
摘要:
A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.
摘要:
Methods of the invention include delivering a grasper, a clip applier, and an endoscope transorally to the site of fundoplication; grasping the fundus with the grasper (or similar device, e.g. corkscrew) and pulling it into the jaws of the clip applier; closing the jaws of the clip applier over the fundus and applying a clip to the fundus.