Abstract: An endoscopic surgical instrument includes a flexible tube, a grasping and fastening end effector coupled to the distal end of the tube, and a manual actuator coupled to the proximal end of the tube. The manual actuator is coupled to the end effector by a plurality of flexible cables which extend through the tube. The tube contains a lumen for receiving a manipulable endoscope and the end effector includes a passage for the distal end of the endoscope. The end effector has a store for a plurality of male fastener parts, a store for a plurality of female fastener parts, a rotatable grasper, a rotatable fastener head for aligning a female fastener part and a male fastener part with tissues therebetween, and a firing member for pressing a male fastener part through tissues grasped by the grasper and into a female fastener part.

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: 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: A biopsy forceps instrument is provided having a proximal actuation handle, a flexible multi-lumen tubular member, at least one control member extending through a lumen, an irrigation means, an aspiration means, and a distal assembly. The proximal actuation handle includes a shaft and a spool slidably mounted on the shaft. The actuation handle is coupled to the proximal ends of both the flexible tubular member and the control member. Lumens of the tubular member form irrigation and aspiration conduits. The distal assembly includes a hollow jaw cup coupled to the aspiration conduit and a hollow movable jaw coupled adjacent the irrigation conduit. The movable jaw is coupled to the control member, such that actuation of the actuation handle moves the movable jaw relative to the jaw cup. Moving the hollow jaws into a closed position provides a substantially fluidtight coupling between the irrigation and aspiration conduits.

Abstract: A colposcopic surgical punch instrument includes a hollow tube and a push rod extending through the hollow tube. A handle is coupled to the proximal end of the tube and an actuation lever is pivotally coupled to the handle and the proximal end of the push rod for effecting axial movement of the push rod relative to the tube. A stationary jaw in the form of a die having an open top and bottom is coupled to the distal end of the tube and a movable jaw in the form of a punch is pivotally coupled to the stationary jaw by a tongue and groove arrangement. In one embodiment, the stationary jaw is provided with a pair of ramped projections on its sides and a tab projection on its distal end. A removable plastic sleeve fits over the stationary jaw. The plastic sleeve has an open proximal end and an open top. A pair of holes in the sides of the sleeve engage the ramped projections on the sides of the stationary jaw and a hole in the distal end of the sleeve engages the distal tab on the stationary jaw.

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: 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 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: 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 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: 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: 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: A bipolar push rod assembly for use 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: A colposcopic surgical punch instrument includes a hollow tube and a push rod extending through the hollow tube. A handle is coupled to the proximal end of the tube and an actuation lever is pivotally coupled to the handle and the proximal end of the push rod for effecting axial movement of the push rod relative to the tube. A stationary jaw in the form of a die having an open top and bottom is coupled to the distal end of the tube and a movable jaw in the form of a punch is pivotally coupled to the stationary jaw by a tongue and groove arrangement. In one embodiment, the stationary jaw is provided with a pair of ramped projections on its sides and a tab projection on its distal end. A removable plastic sleeve fits over the stationary jaw. The plastic sleeve has an open proximal end and an open top. A pair of holes in the sides of the sleeve engage the ramped projections on the sides of the stationary jaw and a hole in the distal end of the sleeve engages the distal tab on the stationary jaw.