Abstract: A bipolar push rod assembly is disclosed in conjunction with an endoscopic bipolar cautery scissors instrument. The push rod assembly has two conductive push rods which are substantially covered and insulated from each other by a double lumen flexible sheath. The proximal ends of the push rods are stabilized by an overmolded plastic collar and the distal ends of the push rods are stabilized by a ceramic insulator. The plastic collar is provided with a snap retainer for coupling it to a plastic plug retainer having a pair of spaced apart passages. A pair of female plug adapters are press fit onto the proximal ends of the push rods and are maintained in place by the plug retainer with each adaptor residing in a respective one of the passages. The distal ends of the push rods are swaged approximately 90.degree. in opposite directions. A ceramic insulator is disclosed as a one-piece unit into which the distal ends of the push rods are inserted.

Abstract: An endoscopic instrument is provided with a hollow tube, first and second end effectors coupled to the hollow tube and having arms biased away from each other, a cylindrical member slidably disposed over the hollow tube, a push/pull wire extending through the tube, a handle assembly coupled to the push/pull wire and the hollow tube, and a disk segment connected to the push/pull wire and connected to the cylindrical member by a crimp in the cylindrical member. When the handle assembly is actuated, the push/pull wire moves the disk segment and hence the cylindrical member relative to the end effectors and causes the cylindrical member to ride over the arms of the end effectors, thereby forcing the end effectors closed or permitting them to open. Preferably, the disk segment has two curved sides which are coupled to the cylindrical member by crimping, and two substantially parallel sides which provide room for the arms of the end effectors so that the disk segment can move relative to the end effectors.

Abstract: 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.

Abstract: An endoscopic forceps jaw assembly for an endoscopic instrument includes a pair of articulating opposed jaws each having a jaw cup. The jaw cups are provided with teeth which increase in height from the proximal end of the jaw cup to the distal end. The jaws are rotatable relative to each other about a common axis and define an open position and a closed position. When the jaws are rotated toward the closed position, the teeth interleave substantially simultaneously. An endoscopic instrument utilizing the jaws of the invention is also provided and further includes an actuation handle, a tubular member, and a control member. The jaw assembly is coupled to the distal end of the control member and rotatably coupled to the distal end of the tubular member, such that the pair of articulable opposed jaws open and close by rotating in response to movement of the control member relative to the tubular member. The jaws may also be electrically conductive and coupled to an electrocautery voltage supply.

Abstract: An automatic suturing instrument generally includes a proximal actuation handle assembly, a flexible tubular member, a control wire, and an end effector assembly. The control wire extends through the tubular member and the end effector-assembly is coupled to the distal end of each of the tubular member and the control wire, while the handle is coupled to the proximal end of each of the tubular member and the control wire. Actuation of the handle moves the control wire relative to the tubular member and thereby moves the end effector assembly from an open to a closed position. The end effector assembly generally includes two end effectors, a needle engaged by one of the end effectors (but which can be engaged by either end effector alternately), and a suture material. The end effector assembly further includes a needle passing mechanism that automatically alternates which end effector engages the needle each time the end effectors are moved into a closed position.

Abstract: An endoscopic bioptome includes a flexible coil having a lumen with an axially displaceable wire extending therethrough. The proximal ends of the coil and wire are coupled to a manual actuator for axially displacing one of the coil and wire relative to the other. The distal end of the coil is coupled to either a jaw assembly or a cylinder. The jaw assembly includes a pair of jaws each having a distal jaw cup having a proximal neck and a relatively narrow bent resilient arm. The distal end of the wire is coupled to the other of the cylinder or the jaw assembly. The cylinder is slidable over the jaw assembly. Axial movement of either the wire relative to the coil or vice versa moves the cylinder over the arms of the jaws and over the necks of the jaw cups, thereby forcing the jaw cups together in a biting action. In one embodiment, the axially displaceable wire is provided with a coaxial stopping band or sleeve which stops its movement as soon as the jaws close.

Abstract: An endoscopic surgical instrument includes a proximal handle assembly coupled to a relatively long coil and to a relatively long pull wire extending through the long coil, and a distal jaw assembly coupled to a relatively short coil and to a relatively short pull wire extending through the short coil. The distal ends of the long coil and pull wire are provided with a first coupling device and the proximal ends of the short coil and pull wire are provided with a second coupling device which is mateable with the first coupling device. The first and second coupling devices couple the distal end of the long coil with the proximal end of the short coil and the distal end of the long pull wire with the proximal end of the short pull wire. The presently preferred pull wire coupling includes a ball and socket coupling and the presently preferred coil coupling includes a bayonet coupling. A rigid endoscopic surgical instrument with a detachable end effector assembly is also disclosed.

Abstract: Endoscopic bipolar scissor blades are formed in a laminate assembly of an outer electrically conductive layer, an intermediate electrically insulating layer, and an inner face layer which is a coating of titanium dioxide, chromium dioxide, or zirconium dioxide. In one embodiment, the conductive layer is a metal blade, while the insulating material is a ceramic which is fixed to the metal blade. In a second preferred embodiment, the insulating layer and the inner face layer are applied simultaneously by coating the metal blade with a mixture of ceramic and titanium dioxide, chromium dioxide, or zirconium dioxide. In a third embodiment, the insulating layer is a molded ceramic blade, and the electrically conductive layer is metalized or otherwise fixed to the ceramic blade. In all embodiments, the cutting edges and shearing surfaces are insulated from the electrodes, and no short circuit can form between the electrodes even though the cutting edges and shearing surfaces are metal.

Abstract: An electrocautery probe includes a pair of arms between which a roller electrode is mounted. The arms are joined at their proximal ends to an electrode lead and a mounting sleeve is provided intermediate of the arms and the lead for slideably coupling the probe to a resectoscope. According to the invention, the roller electrode has an eccentric convex or concave surface to increase the surface area of the electrode. In other embodiments of the invention the electrode is provided with a plurality of longitudinal surface grooves which further increase surface area of the electrode and also enhance traction of the electrode. The electrodes according to the invention are preferably made of copper, chromium cobalt, or carbonless stainless steel. They preferably have an overall diameter of from about 0.115 to about 0.187 inches and an overall length of from about 0.110 to about 0.120 inches.

Abstract: An endoscopic bioptome jaw assembly has at least thee jaws. In one embodiment the assembly includes at least three distally extending resilient arms. Each of the resilient arms terminates in a jaw which includes a substantially hollow distal jaw cup. The resilient arms are bent to urge each jaw away from the other. Each jaw cup has at its distal end at least one end tooth having a cutting edge. An endoscopic bioptome includes a tubular member having a displaceable wire extending therethrough. The proximal ends of the tubular member and wire are coupled to a manual actuation means for axially displacing the flexible member relative to the wire. The distal end of the tubular member is coupled to either a cylinder having a distal edge or to the base of the jaw assembly. The distal end of the wire is coupled to the other of the cylinder or the jaw assembly.

Abstract: An endoscopic multiple sample bioptome includes a hollow outer member and an axially displaceable inner member extending therethrough. The proximal ends of the outer and inner members are coupled to an actuator for axially displacing one relative to the other. The distal end of the outer member is coupled to one of a cylinder having a sharp distal edge and a jaw assembly, while the distal end of the inner member is coupled to the other. The jaw assembly includes a pair of opposed, preferably toothed jaw cups each of which is coupled by a resilient arm to a base member. The arms are bent to lie in planes which intersect the axis of the base member and to locate the jaws apart from each other. The base member is mounted inside the cylinder and axial movement of the jaw assembly and cylinder relative to each other draws the arms into the cylinder and brings the jaw cups together in a biting action.

Abstract: A laparoscopic surgical instrument includes an actuation handle, a control member, a flexible tube, a rigid tube, and an end effector assembly. The control member extends through the flexible tube, and the actuation handle is coupled to the control member and the flexible tube. The end effector assembly is coupled to the control member and the flexible tube. The actuation handle is arranged to move the control member relative to the flexible tube, resulting in the operation of the end effector assembly. The rigid tube extends over the flexible tube and conforms the flexible tube to the shape and curve of the rigid tube. A set of rigid tubes, each curved to varying degrees, may be provided, wherein each tube may extend over the flexible tube and be removably coupled to the handle. The practitioner is able to choose from the variety of rigid tubes the tube which is most appropriate for a procedure.

Abstract: An actuator for an endoscopic instrument includes a handle having a through bore with a distal keyway and a lever which is pivotally coupled to the handle. A proximal tube sleeve is insert molded or press fit to the proximal end of the instrument tube. The tube sleeve has a pair of ramped thread-like projections and a pair of distally facing wedge-like projections all of which pass through the keyway in the handle. A proximal stop ring on the tube sleeve prevents the tube sleeve from passing completely through the handle. A ferrule having a pair of interior threadlike projections threadably engages the tube sleeve and is frictionally engaged by the wedge-like projections. A ferrule locking cap having a proximal inner groove and a distal flange fits in the annular space between the tube sleeve and the ferrule. The proximal groove engages a locking ring on the tube sleeve and splines on the tube sleeve and the ferrule frictionally engage the cap.

Abstract: An air introduction system for a medical needle assembly is provided and includes a flexible bladder, and a male luer assembly with an air valve which is biased to allow air to enter the air introduction system but not to exit. The air introduction system is coupled to a needle assembly which is to be introduced into the epidural space. As the needle traverses the tissue layers overlying the epidural space, and the practitioner applies pressure to the bladder, the practitioner experiences resistance to the forcing of air through the needle assembly. If air is lost from the bladder, the bladder may be refilled by releasing the pressure on it and allowing outside air to enter via the air valve. Once the epidural space is penetrated, air is quickly forced from the bladder through the needle assembly and the practitioner can feel a sudden drop in pressure.

Abstract: An endoscopic biopsy forceps instrument includes an actuation handle having a stationary member coupled to a movable member, a tubular member coupled at its proximal end to the stationary member, a control wire extending through the tubular member and coupled at its proximal end to the movable member, and a biopsy forceps jaw assembly having jaw cups. The jaw assembly is coupled to the distal ends of the tubular member and control wire, such that movement of the movable member relative to the stationary member imparts relative movement of the control wire relative to the tubular member and opens and closes the jaws. The distal end of the stationary member includes a groove for holding a sample removal pick. A sample removal pick shaped to be slidably engaged in the holder is received within the holder. The pick may include catches and ridges for engagement by a human finger, such that the catches and ridges may be engaged by the practitioner to slide the pick out of the holder.

Abstract: A deflection-limiting clevis includes a substantially cylindrical base with a pair of clevis arms extending therefrom, a clevis axle extending between distal ends of the clevis arms and a pair of stops located on interior portions of the clevis arms between the base and the axle. The stops are dimensioned and located to engage respective tangs of a pair of jaws, which are mounted on the axle, when the jaws are deflected across the center line of the clevis. A first embodiment of the clevis may be used with or without a conventional flat needle between the jaws. In a second embodiment of the clevis, a cross member is located between the clevis arms proximal of the clevis axle and distal of the cylindrical base. The cross member may be used to engage the proximal end of a shortened flat needle which is mounted between the jaws and is also used to engage the tangs of the jaws when the jaws are rotated about the axle to a point of deflection.

Abstract: A stamped clevis is made from a stainless steel sheet which is cut (stamped) to form at least one relatively narrow distally extending arm and at least one relatively broad proximal base. The distal arm is provided with at least one mounting hole for receiving an axle pin and the proximal portion is wrapped to form a cylinder or a broken cylinder. In one embodiment, the sheet is cut to form two relatively broad proximal bases and two relatively narrow substantially parallel distal arms, one arm extending from each base and being provided with a mounting hole. The arms are joined by a cross member proximal of the mounting holes and a central tab having a third mounting hole extends distally from the cross member. The cut sheet is formed by bending the cross member on either side of the tab in an "S" configuration so that the mounting holes are aligned substantially coaxially. The two proximal bases are bent towards each other to form a bifurcated cylinder. The tab may be provided with an integral spike.

Abstract: A biopsy forceps instrument includes a flexible coil having one or more pull wires extending therethrough, a clevis coupled to the distal end of the coil, a pair of forceps jaws mounted in the clevis and coupled to the distal end of the pull wire(s), and a proximal handle coupled to the proximal ends of the coil and the pull wires. The handle includes a slotted shaft and a displaceable spool having a cross member which extends through the slot. The shaft is coupled to the coil and the cross member is coupled to the pull wire(s). According to the invention, at least one constant force spring is provided between the shaft and the spool and biases the spool in the proximal direction in order to maintain the jaws in a closed position. According to a presently preferred embodiment of the invention, a pair of flat wound spiral springs are provided with the free flat ends of the springs being coupled to a proximal portion of the shaft.

Abstract: Hermaphroditic biopsy forceps jaws for use in an endoscopic biopsy forceps instrument are made from a flat sheet of stainless steel or other suitable material which is stamped and then progressively formed into a jaw cup having a tang. According to the presently preferred embodiment of the invention, the jaw is provided with two substantially parallel tangs, one being shorter than the other. Both tangs are provided with central mounting holes for mounting the jaw on an axle pin between the arms of a clevis. The longer of the tangs is provided with a hole for coupling it to the distal end of a control wire. The tangs are located such that when the jaws are mounted in the clevis, the short tang of each jaw resides between the two tangs of the other jaw. The stamped jaw of the invention may be provided with or without teeth. The location of the tangs permits the mounting of a knife between the jaws, if desired. Other end effectors of similar construction are also disclosed.

Abstract: An end cap is provided for an endoscopic biopsy forceps instrument having a long coil and a jaw assembly. The end cap is provided with a cup portion, an attachment clip, and preferably a suction cup. The cup portion fits over the closed jaws of the biopsy forceps and has an open end and a closed end, and side walls. The attachment clip extends perpendicularly from the side walls of the cup portion and fits around one or more sections of the biopsy forceps coil, thereby stabilizing the forceps jaw and coil for packaging. The attachment clip can also be used for attaching the cap to the coil of the biopsy forceps instrument when the cap is off of the jaws so that the cap is readily available for later retrieval. The suction cup is coupled to the top of the cup portion and is used both to prevent misplacement and loss of the cap, and to expedite recapping after usage.