초록

A laparoscopic surgical device is provided, including a ratchet mechanism. The ratchet mechanism includes a single button or lever that may be used to release or defeat a ratchet engagement.

대표청구항 ▼

We claim: 1. A surgical instrument having a handle operatively connected to an elongate shaft, the handle comprising: a thumb ring member pivotably connected to a finger ring member; a first engagement member fixed in and projecting generally distally from the thumb ring member; a second engagement

We claim: 1. A surgical instrument having a handle operatively connected to an elongate shaft, the handle comprising: a thumb ring member pivotably connected to a finger ring member; a first engagement member fixed in and projecting generally distally from the thumb ring member; a second engagement member pivotably mounted to and projecting generally proximally from the finger ring member, a first end portion of the second engagement member being biased into engagement with the first engagement member and defining an engaged state; and an elongate cam member pivotably connected to the finger ring member and comprising an operative contact with a second end portion of the second engagement member; wherein, the elongate cam member is at a first angle relative to the second engagement member, the operative contact is sufficient to pivot the second engagement member so as to overcome the biased engagement of the second engagement member with the first engagement member defining a released state; wherein, when the elongate cam member is at a second angle relative to the second engagement member, the operative contact is sufficient to pivot the second engagement member so as to overcome the biased engagement of the second engagement member with the first engagement member and is sufficient to bias the second engagement member out of engagement with the first engagement member defining a defeated state; and wherein the elongate cam member, first engagement member, and second engagement member are configured such that, when the handle occupies the engaged state, the elongate cam member is disposed intermediate the first angle and the second angle. 2. The surgical instrument of claim 1, wherein the operative contact of the handle to the elongate shaft comprises: an externally indexed rotation knob attached to an exterior surface of the elongate shaft, the knob configured to rotate the elongate shaft around its longitudinal axis; and a rotation-permitting retaining connection of the second handle member to the elongate shaft. 3. The surgical instrument of claim 2, further comprising: an indexed detent connection of the second handle member to the elongate shaft, the indexed detent connection comprising: a ball detent disposed in a cavity adjacent a distal end of the second handle member; a longitudinally grooved exterior surface portion near the proximal end of the elongate shaft; and an o-ring, said o-ring retaining the ball detent in the cavity and biasing the ball detent into indexing contact with the longitudinally grooved exterior surface portion of the elongate shaft. 4. The surgical instrument of claim 1, wherein the elongate shaft comprises an actuation rod extending longitudinally therethrough and the actuation rod includes a proximal-end rod-retention structure that is of greater diameter than a majority length of the actuation rod; and the thumb ring member comprising an actuation rod retainer, the actuation rod retainer including a distal keyhole groove configured to retain the proximal-end retention structure. 5. The surgical instrument of claim 4, further comprising a generally tubular bearing member disposed at least partially around a proximal portion of the actuation rod. 6. The surgical instrument of claim 5, wherein the generally tubular bearing member provides electrical insulation around at least a proximal portion of the actuation rod. 7. The surgical instrument of claim 5, wherein the generally tubular bearing member comprises a connector for retaining the actuation rod. 8. The surgical instrument of claim 4, further comprising an electrode in conductive contact with the actuation rod. 9. The surgical instrument of claim 4, wherein the proximal-end rod-retention structure is generally spherical. 10. The surgical instrument of claim 4, wherein a metal insert is disposed in the distal keyhole groove. 11. The surgical instrument of claim 1, wherein the elongate shaft comprises an actuation rod extending longitudinally therethrough and a longitudinally grooved exterior surface portion near the proximal end of the elongate shaft. 12. The surgical instrument of claim 11, wherein the finger ring member comprises a generally cylindrical bearing component disposed in an upper region thereof, the bearing component comprising: a central longitudinal lumen through which a proximal portion of the actuation rod fully extends, a distal portion of said lumen disposed around a longitudinally grooved exterior proximal portion of the elongate shaft; a ball detent disposed in a cavity in the distal portion of the bearing; and a groove immediately adjacent the cavity, said groove seating an o-ring, and said o-ring being configured to retain the ball detent in the cavity and to bias the ball detent into indexing contact with the longitudinally grooved exterior proximal portion of the elongate shaft. 13. The surgical instrument of claim 12, wherein the elongate shaft is retained in the distal portion of said lumen by a threaded connector. 14. The surgical instrument of claim 1, further comprising a cushioning insert disposed on a region selected from the finger ring member, the thumb ring member, or both. 15. The surgical instrument of claim 1, further comprising a finger rest projecting generally downward from the finger ring member. 16. The surgical instrument of claim 1, further comprising a textured surface on an upper proximal surface of the thumb ring member. 17. The surgical instrument of claim 1, further comprising a textured surface on an intermediate side surface of the thumb ring member. 18. The surgical instrument of claim 1, wherein an upper portion of the thumb ring member and an upper portion of the finger ring member are configured and coupled such that an actuation rod disposed slidingly through the finger ring member and connected to the thumb ring portion is shielded from contact by a hand of a user. 19. A surgical instrument having a handle operatively connected to an elongate shaft according to claim 1, wherein: the thumb ring member comprising a plurality of raised thumb-grip ridges disposed on an upper proximal surface of the thumb ring member, said ridges configured to provide a frictional gripping surface. 20. A surgical instrument having a handle operatively connected to an elongate shaft according to claim 1, wherein: the thumb ring member comprising a plurality of raised thumb-grip ridges disposed on an intermediate side surface of the thumb ring member, said ridges configured to provide a frictional gripping surface. 21. A surgical instrument having a handle operatively connected to an elongate shaft, the handle comprising: a first handle member pivotably connected to a second handle member; and a ratchet mechanism removably engaging the first and second handle members, the ratchet mechanism comprising: a ratchet-toothed engagement member fixed to and projecting generally distally from the first handle member; an L-shaped pawl member having a camming leg portion and a pawl leg portion generally perpendicular to the camming leg portion, the L-shaped pawl member pivotably mounted in the second handle member such that the pawl leg portion projects generally proximally from the second handle member, an upper region of the camming leg portion comprising a generally vertical camming surface and a distally projecting camming surface; a cam lever; a biasing spring mounted in the second handle member and operatively contacting the L-shaped pawl member such that a proximal end region of the pawl leg portion is biased into engagement with the ratchet-toothed engagement member when the cam lever is disposed at a neutral angle; and the cam lever pivotably connected to the second handle member, the cam lever comprising a first operative contact with the L-shaped pawl member such that when the cam member is disposed at a first angle relative to the L-shaped pawl member, the first operative contact is between the cam lever and the distally projecting camming surface, said first operative contact being sufficient to pivot the L-shaped pawl member so as to overcome and release the biased engagement of the pawl leg portion with the ratchet-toothed engagement member; and wherein, when the cam lever is disposed at a second angle relative to the L-shaped pawl member, a second operative contact between the cam lever and the generally vertical camming surface is sufficient to pivot the L-shaped pawl member so as to overcome and defeat the biased engagement of the pawl leg portion with the ratchet-toothed engagement member and is also sufficient to bias the L-shaped pawl member at an angle wherein the pawl leg portion is not engaged with the ratchet-toothed engagement member; and wherein the neutral angle of the cam lever is between the first angle and the second angle relative to the L-shaped pawl member. 22. A method of use of a surgical instrument, the method comprising the steps of: providing a surgical instrument having a handle, the surgical instrument handle comprising a thumb ring member pivotably connected to a finger ring member; a ratchet-toothed arm fixed in and projecting generally distally from the thumb ring member; an L-shaped pawl member pivotably mounted to and comprising a first end portion projecting generally proximally from the finger ring member; and a cam lever pivotably connected to the finger ring member and comprising an operative contact with a second end portion of the pawl member, the first end portion of the pawl member being spring-biased by a spring into engagement with the ratchet-toothed arm when the cam lever is at a default first angle relative to the finger ring member; pivoting the cam lever to a second angle relative to the finger ring member, wherein the operative contact is sufficient to pivot the pawl member so as to overcome the spring bias and release the engagement of the first end portion of the pawl member with the ratchet-toothed arm; and pivoting the cam lever to a third angle relative to the finger ring member so that the spring biases the second end portion of the pawl member against the cam lever such that the engagement of the first end portion of the pawl member with the ratchet-toothed arm is defeated, wherein the position of the cam lever at the default first angle is between position of the cam lever at the second angle and at the third angle. 23. A surgical instrument having a handle ratchet mechanism with a single-button release/defeat feature, the handle ratchet mechanism comprising: a first engagement member; a second engagement member pivotably mounted to a handle portion and projecting toward the first engagement member; a spring member biasing a first end portion of the second engagement member into engagement with the first engagement member; and a cam button pivotably connected to the handle portion and comprising an operative contact with a second end portion of the second engagement member; wherein, when the cam button is at a first angle relative to the second engagement member, the operative contact is sufficient to pivot the second engagement member so as to overcome the biased engagement of the second engagement member with the first engagement member; wherein, when the cam button is at a second angle relative to the second engagement member, the operative contact is sufficient to pivot the second engagement member so as to overcome the biased engagement of the second engagement member with the first engagement member and is sufficient to bias the second engagement member out of engagement with the first engagement member; and wherein when the cam button is at a third angle, between the first and second angles, the operative contact permits the biased engagement of the second engagement member with the first engagement member. 24. A surgical instrument having a handle operatively connected to an elongate shaft, the handle comprising: a thumb ring member pivotably connected to a finger ring member; a toothed first engagement member comprised by the thumb ring member; a second engagement member pivotably mounted in the finger ring member; and an elongate cam member movably connected to the finger ring member and comprising an operative contact with a second end portion of the second engagement member; wherein a first end portion of the second engagement member is biased into engagement with the toothed first engagement member by a spring member when the elongate cam member is disposed in a neutral position; wherein, when the elongate cam member is in a first position relative to the second engagement member, the operative contact is sufficient to move the second engagement member such that the operative contact provides a force sufficient to overcome the biased engagement of the second engagement member with the toothed first engagement member; wherein, when the elongate cam member is in a second position relative to the second engagement member, the operative contact is sufficient to move the second engagement member so as to overcome the biased engagement of the second engagement member with the first engagement member and is sufficient to bias the second engagement member out of engagement with the first engagement member; and wherein the neutral position of the elongate cam member is between the first position and the second position.