CA2074798A1

CA2074798A1 - Surgical forceps

Info

Publication number: CA2074798A1
Application number: CA002074798A
Authority: CA
Inventors: Robert M. Weber
Original assignee: Individual
Current assignee: Linvatec Corp
Priority date: 1991-07-29
Filing date: 1992-07-28
Publication date: 1993-01-30
Also published as: US5286255A; DE69217814D1; DE69217814T2; ATE149318T1; AU655810B2; EP0538984A2; EP0538984A3; JPH05184588A; EP0538984B1; AU1511292A

Abstract

ABSTRACT A surgical forceps particularly useful in least invasive surgery includes an elongate probe formed of an outer tubular member and an inner member movable in the outer probe member, stationary and movable jaws coupled with the distal ends, respectively, of the outer and inner probe members, and a handle squeezable to move the movable jaw relative to the stationary jaw to rearwardly or forwardly cut tissue or to grasp tissue. A force diverting mechanism is responsive to the force applied to the handle exceeding a predetermined force to provide the surgeon with an indication of the excessive force and protects the jaw components at the distal end of the surgical forceps. A suction passage is formed in the forceps for aspirating cut tissue and assisting the positioning of tissue between the jaws, and suction can be produced continuously or controlled via the handle. The handle includes locking and latching mechanisms to hold the jaws in a closed position.

Description

BACKGROUND OF THE INVENTION

1 Field of The Invention 2 The present invention pertains to intra-articular devices and, 3 more specifically, to surgical suction forceps for cutting or 4 grasping tissue and applying suction.

Description Of The Prior Art 6 lntra-articular surgical d~vices for cu~ting and aspirating 7 tissue from th~ body are well known, as exemplified by the C-Cutter 8 of the IntraArc Arthroscopy Blade System of Concept and as ~urthar 9 exemplified by U~S. Patents No. 4,986,825 to Bays et al and ~o~.
4,662,371 and 4,522,206 to Whippl~ et al. Such surgical devices or 11 instrument~ typically include a movable jaw and a stationary jaw 12 mounted, respectively, on distal ends o~ relatively movable inner 13 and outer tubular members to permit the jaws to engage tissue when 14 the movable jaw is ~oved relative to the ~tationary jaw in response to movem~nt of the innar tubular memb~r produced by a drive at the 16 proximal end o~ the in~trumen~. Wi~h the lnner and ou~er tubular 17 member~ having an elongate configuration, surgical cutting and 18 grasping in~trum~nt~ charac~çrized by cooperating, clo3able jaws 19 hava particular utility in closod, or lea~t invasivo, surgical procedure~, including arthroscopy, by allowing th~ jaw~ to be 21 po~itioned to engaqQ tis~ue at a surgical it~ via ineertion 22 through a .mall portal with ~inimal trauma. Such in~truments are ~3 r~f~rred to h~rein a~ uction ~src~p~. Th~ jaws of ~uch suction 2 ~
1 forceps can be driven either manually, as exempli~ied by th2 2 Whipple et al patents and by the various Shutt forcep~ of Concept, 3 or with a power drive as ~xempli~ied by the Concept IntraArc 4 Arthroscopy Power System and C-Cutter and the ~ays et al patent, the drive serving to move the inner elongate member relative to the 6 out~r elongate member to, in turn, open and close the ~aws.
7 Some of the disadvantages of prior art suction :eorceps are 8 that, when the jaws are operated or driven manually by a pivotal 9 handle, components at the distal end can be broken if excessive ~orce is applied to the handle cre~ting the opportunity for sevaxed 11 parts to be introduced at the surgical site and that the movable 12 jaw is unable to scoop up and cut tissue in a rearwardly directed 13 cutting action and is generally incapabla of readily cutting 14 tissuo position~d ~o as to requir~ a "bac~biting" cutting action.
Additionally, the movable jaws in manually oparable suction forceps 16 frequently cannot be e~fectively locksd in a '3closed" position for 17 sa~ety in handling the in ~rument3 a~d ~or enhanced manipulation in 18 closely confin~d surgical sites. Locka propos2d in tha past for 19 secuxing manually movable operating handles in a posi~ion corre~pondlng to a clo~ed position ~or the movabl~ jaws are 21 structurally and functionally co~plicatPd and are incompatible ~or 22 usa und~r th~ time constraints o~ surgery. Moreov~r, ~he locks 23 ~requently ar~ acciden~ally d~fea~ad during nor~al handling o~ the 24 ~urgical in3trumenks and, there~or~, ar~ unreliable. When cooperating/ clo~able ~aws ~r~ us~d to grasp tissu~, the grasping )s3~

1 ja ~ must be securely closed around the tissu~ to obtain a firm 2 holding grip thereon. In many cases, it is difficul~ to reach 3 tissue with the grasping jaws or to initially draw tis~ue between 4 the jaws when the jaws are positioned proxlmate, but in less than direct engagement with, tissue.

6 SU~MARY OF T~E INVENTION
7 Accordingly, it i~ a pri~ary object of the preRant invention 8 to overcome tha above mentioned disadvantages of prior art suction 9 ~orcep~ for cutting and/or grasping tissue.
Another object o~ the pr~sent invention is to divert ~orce 11 applied to a handle o~ a surgical forceps when the applied rorce 12 exceeds a pred2ter~ined ~orce to provide a tactil~ indication of 13 excess ~orce via th~ handle and to prevent damage to and breakage 14 o~ co~ponents at th~ distal end of thQ forceps.
The present invention has another object in th~ control of '6 suction through a suction forceps by manipulation o~ handle grip '7 me~ber3.
'8 It is also an objec~ o~ the present invention to provide a '9 suction ~orcep~ having coopera~ing, closa~l~ cutting jaws for cutting ti~ua at a surgical,~ite while suction i8 produced at the 21 surgical ~it~ con~inuou~ly with suc~ion produc~d at th~ jaws via a 22 suction pa ~age in th~ ~uction ~orcep~.
2 3 A ~urther ob~ ~c~ o~ ~h~ pre~n~ inv~n~ion i3 ~0 provide a 24 ~uction ~orcep~ ha~ing coop~rating, closabla gra~ping jaws ~or gra~ping tis~u~ whi~a suction i~ produced at the grasplng ~aws via 4 i l a _lction passage in the suction forcep~ to initially draw tissue 2 between the grasping jaws when the grasping jaws ara in an open 3 position.
4 Additionally, it is an object of the present invention to tactilely indicate when a ~orce applied to h~nd grip memhers 6 exceeds a predetermined ~orce ~o prevent damage and/or hreakage of 7 components at th~ distal end of a surgical forceps.
8 It is also an object of the present invention to lock 9 cooperating, closable jaws of a surgical forceps in a closed 10 po~ition while preventiny locXing when the jaw~ ara not in the ll clo~ed position and preventing accidental relea~e from the locked 12 position.
13 Furthermor~, it i5 an obj~ct o~ the present invention to 14 providQ a suction forcep~ having a movabl~ cutting jaw mounted on 15 a distal end thereof for movement through an opening in a 16 stationary cutting jaw to position a distal end o~ the movable 17 cutting jaw adjacent a proximal end o~ tha opening to cut tissua 18 through the opaning in a rearward cutting action.
l9 Soma o~ th~ advantage3 o~ tha pres~nt invention over the prior 20 art are that the ~urgical forcep~ i3 suitable for use wikh diverse 21 cutting j aw~ a~ w~ll a~ gras~ing jaws, i~ manually oparable in a 22 manner ~amiliar ko surg~on~ and producas a fa~t and ef~icient 23 cutting action with unconstricted a~piration Or cut tlssue while 24 damage ~o co~ponant~ during usa is mini~ized.

l The surgical forceps of the present invention is generally 2 charai~terized by an outer elongate tubular member having a distal 3 end and a proximal end and an inner elongate tubular member 4 slidably disposed in the outer tubular member and having a distal end and a proximal end. A stationary jaw is disposed on the distal 6 end o~ the outer member, and a movable jaw is pivotally mounted on 7 the stationary jaw. A cam meohanism translates sliding ~o~ement of 8 the inner mem~er relative to the outer me~ber into pivotal movement 9 of the movable jaw relativQ to the ~tationa~y jaw between an open position and a closed position to engage tis~ue between the jaws.
11 The proximal end~ of th~ inner and outer members are dispos~d in a 12 handl~ body containing an actuating mechanism for sliding the inn~r 13 m~mber within the outer member in response to pivotal movement o~
14 a hand grip memb~r. The actuating mechanism includ~s a tubular ~ha~t having a first end receiving the proximal end o~ tha inner 16 member and a second ~nd slidably dispo~ed in a suction fitting in 17 the handle body for producing suc~ion through the ~haft and the 18 inner member when the suction fitting i~ connected to a vacuum 19 source, the tubular sha~t being bia~ed to maintain the jaws in the op~n position~ A push ring is ~lidably di~posed on the tubular 21 sha~t in Qngage~Qnt with the~movabla grip memb~r and i9 biased to 22 uncover hol~ in th~ tubular 3haft in alignment with a window in 23 the handle body to diYert suction Pro~ th~ jaw~ Plvotal mov~ment 24 of th~ grip m~mb~r cau~ the pu5h ring to ~lid~ r~lativQ to the ~5 tubular ~ha~t to covQr th~ holes and ~s~abli~h uction at tha ~aws.
26 Suction i9 di~tributed around the ~aw~ to ini~ially draw tissue r) 1 therebetween, and further movem~nt of the grip member ca~ses the 2 tubular shaft andl therefore, the inner memberl to slide relative 3 to the outer member to pivot the movable jaw to the closed 4 position. When ~he jaws are grasping jaws, suction at the jaws supplements the holding force of the jaws: and, when the jaws are 6 cutting jaws, cut tissue is aspirated through an unconstricted 7 suction passage. When cutting jaws are utilized, an aperture is 8 provided in the stationary jaw in communication with t:he suction 9 passage and the surgical ~ite to produce ~uction at the suryical 10 sitQ continuously through the jaws. When a ~orc~ exceeding a 11 predetermined forc~ is applied to th~ handlQ, the urgeon is 12 tactilely and visually alerted to th~ application o~ potentially 13 damaging operating for~e~. A lock is movably mounted in th~ handle 14 body ~or selective movement to a locked position when the handle is 15 in a position corre ponding to thQ cloRed position for the jaws, 16 and th~ lock is prevent~d from being moved to the locked position 17 when t~s jaws ar~ not in the closed position. A latch integral 18 with the handl~ body is biased to secure ths lock in the locked 19 position. The ~aws can ba used ~or cutting tissue in a forwardly 20 directed cutting action or in a rearwardly directed, or 21 "backbiting", or ~or grasping ti~su~.
22 O~her ob~ct3 and advantag~s o~ th~ prQsent invention will 23 become apparent ~ro~ th~ ~ollowing d~scription o~ the pre~erred 24 embodiments taken in conjunction with the acco~panying drawings 2$ wher~in like parts in each o~ the sev~ral ~igur~s are ldQntified by 2~ th~ ~am~ re~er~nc~ charact~r~.

~4~

2 Fig. l is a side view of a suction cutting forceps according 3 to the present invention.
4 Fig. 2 is a partial longitudinal sectional view o~ the suction forceps of Fig. 1.
6 Fig. 3 is a broken, partial longitudinal sectional view of the 7 suction forceps of Fig. 1 showing cutting jaws locked in a closed 8 position.
9 Fig. 3A iq a broken sid~ view of a side wall of a handle ~ody of the suction forceps o~ Fig. l.
ll Fig. 4 iq a sidQ view, partly in section, of a distal end of 12 th~ suction forceps of Fig. l.
13 Fig. 5 is an exploded view of inner and outer tubular ~embers 14 and the actuating mechanism o~ the suction forceps of Fig. 1.
Fig. 6 is an exploded view o~ an overload forc~ indicator of 16 tha quction forc~p~ o~ Fig. l.
17 Fig. 7 is a broken side view of a di~tal end of a suction 18 grasping forc2p~ according to th~ pres~nt invention.
19 Fig. a i~ a partial longitudinal sectional vi~w of the ac~uating m~chani~m of the suc~ion forc~ps of Fig. l.
21 Fig. 9 is a ~id~ ViQW, ~artly in section, o~ a distal end of 22 a modification of th~ ~uction cutting forceps according to the 23 present inventionl 2 A surgical suction cutting forceps 10 according to the present 3 invention is shown in Figs. 1 - 6 and include~ an elongate probe 11 4 . ~ormed of outer elongate tubular member 12 having a distal end 14 and a proximal end 16 and an inner elongate tubular member 18 6 slidably disposed within the outer tubular member 12 and having a 7 distal end 20 and a proximal end 22. A stationary cutting jaw 24 8 and a movable cutting jaw 26 are disposed, respectively, at the 9 distal ends 14 and 20, and th~ proximal ends 16 and 22 are received in a handle body 28. A~ shown in Fig. 4, the stationary cutting 11 jaw 24 include~ a tubular end 30 jsin~d to the distal end 14 of the 12 out~r member 12, such as by braæing or tha lika, a s~mi-cylindrical 13 wall 32 joined to the lower part o~ the tubular end 30 and an end 14 wall 34, arcuate in con~iguration wh~n viewed ~rom above, joined to thQ semi-cylindrical wall 32. A sur~aca 36 on the end wall 34 and 16 the semi-cylindrical wall 32 curves upwardly in the proximal 17 direction fro~ ths end wall 34 to a~ upp~r part o~ the tubular end 18 30 to d~ine a peripheral cutting edgo on the in~er surface o~ the 19 stationary cutting jaw ~4 circumscribing an opening 38 on the upper side leading into a chamber 40. A r~ctangular ~lot 42 intsrsecting 21 the opening 38 i~ ~ormed in ~he uppQr par~ of the tubular end 30 to 22 exkend l~ngthwi3Q ~rom the op~ning 38 in the proxi~al direction.
23 An ap~rture or opening 44 i~ ~ormed in the lower ~id~ o~ the semi-24 cylindrical w 11 32 adjace~t an inner sur~ac~ o~ ~he end wall 34 in ~luid co~munioation with the chamb~r 40, the ap~rture ~4 having a 26 di~tal edge aligned with a distal portion o~ ~h~ cuttlng edge 1 fo~med by opening 38. A ~ore 46 is formed through the tubular end 2 30 transverse to the longitudinal axis of the outer member 12 and 3 in alignment wlth the slot 42, and the longitudinal axis o~ the 4 bore 46 is positi~ned between the longitudinal axis of the outer member 12 and the slot 42.
6 The movable cutting jaw 26 includes a curved top wall 48 7 joined to a distal end wall 50 that is arcuate in con~iguration 8 when viewed from below and side wall~ 52 joined to end r"all 50 and 9 top wall 48. An arcuate cutting edge 54 is formed on the end wall 50 o~ a cutting portion o~ the movable jaw, and inwardly curving 11 sida cutting edge~ 56 are formed on the sidz walls 52 ~or movem~nt 12 past the cutting edge on th inner sur~ace o~ thQ stationary 13 cutting jaw 24. An opening 58 i~ formed in the top wall 48 14 communicating with a recess extending laterally between the side wall~ 52 such that tha 3idQ wall~ 52 d~fin~ spac~d, parallel ears ~6 60, on an actuating portion o~ the movable jaw. Bores 62 and 64 17 ar~ ~ormed transversely through th~ ear3 60 in spaced parallel 18 r~lation. Th~ bor~ 62 is alignad with the bora 46 in the 19 sta~ionary cutting jaw 24, and a pivot pin 65 is in~exted through th~ align~d bora~ 62 and 46 to pivotally mount th~ movable cutting 21 jaw 26 on ~hQ ~tatiGnary cutting jaw 24 at a pi~ot point disposed 22 proximally o~ ap~rtura ~4.
23 A cam ~6 is mounted on the open diRtal end 20 o~ tha inner 24 ~ber 18 and include~ a cylindrical body 68 joined coaxially to th~ di~tal and 20, such as by brazing and th~ lik~, and a pair of 26 spac~d, parall~l prongs 70 pro~ectlng longitudinally in a distal 10 ' ~ ~ 7 ~ r~ 9 8 1 direction from an upper part of the cylindrical body 68. The end 2 o~ the cylindrical body 68 is open and angularly disposed with the 3 longitudinal axis o~ the inner member 18, and th~ open end 72 4 communicates with th~ chamber 40 and the lumen of the inner member 18. A bore 74 is formed transversely through the prongs 70, and 6 the longitudinal axis of the bore 74 i5 disposed above the 7 longitudinal axi~ of the inner memher 18. An actuator or cam 8 follower 76 for translating sliding movemant o~ the inner m~mber 18 9 into pivotal movement o~ the movable cutting jaw 26 includes a rigid plate of substantially constant thickne~s having a circular 11 jaw end 80 and a circulax cam end 82 ~oined to the jaw end 80 by a 12 central neck 84. A bore 86 is formed centrally in the jaw end 80, 13 and a bor~ 88 is ~ormed centrally in the cam end 82. The ~aw end 14 80 is positioned between the ears 60 on the movabl~ cutting jaw 26 lS to align the bore 86 with the bore 64, and a pivot pin 89 is 16 inserted through the aligned bores 86 and 64 to pivotally connect 17 the actuator 76 with tha actuating portion o~ th~ movable cutting 18 jaw 26. ThQ cam end 8~ i~ positioned b~tween the prongs 70 on the 19 cam 66 to align ~ bor~ 8~ with ~hQ bor~ 74, a~d a pivo~ pin so is in~erted through th~ aligned bores 88 and 74 to pivotally connect 21 th~ actuator 76 with thQ c~m 66, the apQrturQ 72 in the cam 66 22 b~ing proxi~ally ~paced ~rom proximal ends o~ the ~tationary and 23 movabl~ jaw~ 24 and 26.
24 A~ ~hown in Pig~. 2 and 3, th~ handle body 28 has an upper interior through pa~sag2 92 rec~iving the proximal end~ 16 and 22, 26 r~ pectively, oX the outer and inner member~ 12 and 18, a lower ~ ~ fj~

1 in~erior passage 94 disposed parallel to the upper passage 92 and 2 an intermediate interior passage 96 perpendicularly ~oining the 3 upper and lower passages 92 and 94. A ~ixed hand grip member or 4 handle 98 is integrally joined to the handle body 28 adjacent a rearward end of the passage 94 and dep~nds rearwardly from the 6 handle body 28. A window 100 is formed in a top wall 102 of the 7 handle body 28 in alignment with the intermediate pas~age 96 and 8 opening into the upper passage 92. A port 104 angularly disposed 9 with the inte~mediate passage 96 extend~ through a ~r~nt wall 106 of the handle body 28 in com~unication with thQ intarmediate 11 pas~aga 96. A cylindrical nos~ plug 108 is di~posed at a ~orward 12 end o~ the upper passage 92 and include~ a first bor~ section 110 13 sacursly recQiving the proximal end 16 o~ the outer msm~er 12 and lg a second borQ sQction 112 having an enlarged annular ri~ extending from a rearward ~id~ o~ an interior radial shoulder 116 at the 16 forward end of the upper passage 92. Th2 ~ir~t bore SQCtion 110 iS
17 externally threaded along part o~ the longitudinal length thereo~
18 for receiving an internally thread~d nos~ cap 118 positioned in 19 engagement with a ~orward sidQ o~ th~ ~houlder 116. A tubular sha~t 120 is ~lidably disposed in tha upp~r pa3sag~ 92 and includes 21 a rorward end slidably dispo ed in the sQcond bore sec~ion 112 of 22 t~e nose pluq lQ8 and ~ecurely receiving th~ proximal end 22 o~ the 23 inner memh~r 18. A r~arward end o~ the cylindrical 3ha~t 120 is 24 ~lidably r~ceived in a hollow suction ~itting 122 threadedly secursd in a rearward end of the uppQr pa3sagQ 92. ~ tubular 26 ex~en~ion 124 on ~h~ suction fltting 1~2 allow~ the suc~on fitting .

,, 1 to be connected to a vacuum source to produce suction through the 2 tubular shaft 120, the inner member 18 and the cam 66, which define 3 a continuous suction passage having no constrictions therein. The 4 tubular shaft 120 ext~nds through an annulax retaining washer 126 positioned in abutment with the annular rim of the second bore 6 section 112 of the nosa plug 108, and a yenerally C-shaped clip 128 7 is secured on the tubular shaft 120 in a recess spaced rearwardly 8 from the retaining washer 126. A coiled actuating spring 132 is 9 disposed around tha tubular shaft 120 between the r~taining washer 126 and the clip 128 and i~ mounted in compres~ion to urge the 11 tubular sha~t 120 and, there~ore, the inner member 18, in a 12 rearward direction. A generally C-shaped stop 134 i~ secured on 13 the tubular sha~t 120 in a recess rearwaxdly paced from the clip 14 128 such that ~h~ 5top 134 abuts an annular wa~her 13~ po itioned adjac~nt tho ~uction ~itting 122 to limit rearward movement o~ the tubular sha~t 120 under the biasing ~orce o~ the actuating spring 17 132. A~ ~hown in Fig. 8, suction divsrting holes 140 are for~ed in 18 th~ tubular shaft 120 at 9C ~paced location~ rearwardly spaced 19 ~rom the clip 128 to ba dispo~ed in the inter~ediate passage 96 in the handle body 28 in alignment with th~ window 100. A cylindrical 21 push ring 14~ i~ slidably c~rried on the tubular ~ha~t 120 ~or 22 movement betweQn ~ha clip 128 and the stop 13~ and include~ an 23 enlar~ed ~lang~ derining a ~orward shoulder 144 and a rearward 24 ~hould~ 146. A coiled ~uction spring 148 is dispo~ed around the tubular ~ha~t 120 and mount~d in co~pre~ion betw~an the clip 128 1 a. . the ~orward shoulder 144 to bias the push ring 142 in the 2 rearward direction and expose the holes 140 as ~hown in Fig. 8.
3 A movable hand grip member ox handle 150 is pivotally mounted 4 on the handle body 28 and includes a hand grip 152 depending angularly from an elbow or mounting section 153 and an actuating 6 arm 154 angularly joined to the elbow 153 to extend upwardly 7 there~rom. The actuating arm 15~ i positloned in the i:ntermediate 8 passage 96 of the handlQ body 28, and a recess 156 in the elbow 153 9 is longitudinally aligned with ~he lower passage ~4. A bore is formed through the elbow 153 transverse to and longitudinally 11 aligned with tha longitudinal axi~ of th~ lower passage 94. As 12 shown in Fig. 1, tracks or slotq 160 are ~ormed in opposing side 13 walls of the handle body 28 in lat2ral alignmQnt with the bore in 14 the elbow 153. A pivot pin 158 i~ di~po~d in the bore in the elbow 153, and opposing end~ o~ the pivot pin 158 are slidably 16 disposed in th~ tracks 160 to be visible alo~g the ~ide walls of 17 the handl~ body 2S. ~ pair o~ spaced, parallel finger3 162 are 18 de~in~d on the actuating arm 154, and the tubular shaft 120 is 19 longltudinally di~po~d between ~he ~inger~ 162 ~uch tha~ the rearward ~houldQr 146 o~ the pu h ring 142 i~ biased by th~ suction 21 spring 14~ lnto ~ngage~n~,~ith the ~ingor3 162 and urges the 22 ~inger~ 1~2 rearwardly against th~ ~top 134 as ~hown in Fig. 2.
23 As ~hown in F~g~. 2 and 6, an o~erload ~orcQ diverter and 24 indicator mechani~ includ~ a circular di~k 166 31idab1y disposed in thQ lower passag~ 94 and an ~longat~d cylindrical hoIder 168 26 pro~ecting forwardly ~rom the cent~r of the disk 166 into the 14 ;

1 r~^ess 156 in the elbow 153. A notch 170 is formed in a forward 2 end of th~ holder 168, and the pivot pin 158 is held within the 3 notch 170. A ~orce overload coiled spring 172 is mounted in 4 compression in the lower passage 94 between the disk 166 and a cylindrical compressor 174 threadedly received in the lower passage 6 94. The compressor 174 selectively maintains the overload spring 7 172 in co~pression suoh that the overload spring 172 biases the 8 disk 166 against a tapered forward end of the lower passage 94 to 9 permit the holder 168 to position the ends of the pivot pin 158 at ~orwardmo~t ends o~ ths tracks 160 and thQ elbow 153 against a 11 forward wall of the intermediate passage 96. For additional 12 strengkh, a second overload spring 177, a~ illus~rated in Fig. 6, 13 can be disposQd within thQ spring 172 to ~ngage the disk 166 and 14 the compressor, respecti~ly. Th~ bia~ing force o~ th~ overload spring against th~ di~k 166 and, ther~for~, the pivot pin 158, i~
16 controlled by adjusting tho compressor 174 to maintain the pivot 17 sha~t 158 at th~ ~orwardmost end~ of the track~ 160 and the elbow 18 153 against the ~orward wall o~ the interm~diate passage 96 when 19 a~plied ~orce to th~ grip ~Q~b~r~ is le~ than a pr~determined ~orc~
21 As shown in Fig~. l, 2 and 3, a locking pin 178 is disposed 22 transv~r~aly in the intQr~diat~ pa ~age 96, and opposing end~ of 23 ~h~ locking pin 178 pro~et latarally ~rom th~ ~idQ wall~ o~ the 24 handle body 28. A curved ~lot 180 is ~or~ad in ~ach of ths ~ide wall3 o~ th~ handlQ body 28 to slidably recaiv~ the opposing ends 26 o~ thQ lockin~ pin 178, and end cap~ 182 are provid~d on the 27 opposing end~ o~ the locking pin 178 ~xteriorly o~ th~ sida walls 1 t ?ermit the end caps 18~ to be manually grasped for moving the 2 locking pin 17~ within the intermediata passagP 96 guided by the 3 slots 180. A plunger 184 is mounted in a hole in the actuating 4 arm 154 of the movabla handle 150 medially between the elbow 153 and the fingers 162. ~he plunger 184 includes a tip 186 positioned 6 in the path o~ movement for the locking pin 178 and blocking 7 movement of the locking pin 178 when the locking pin 178 is 8 dispos~d at th2 lowermost end~ o~ th~ slots 180 and ~he movable 3 handla 150 i5 biased against tha stop 134 as shown in ~ig. 2. As :0 shown in Fig. 3, the plunger 184 move~ wi~h the movable handle 150 ~1 when the movable handls 150 i~ rotated or pivoted about pivot pin '2 158 to po ition the tip 186 beyond th~ path o~ movement for the _3 locking pin 178 and permit the locking pin 178 to be moved ~ro~ the 14 low~rmost to the uppermo~t ends of th~ 810t3 180. AR shown in Fig.
i5 3A, curved spring latche3 188 ar~ integrally formed in th~ side ~6 walls of the handle body 28 along ~orward edges o~ the slots 180 i7 and are bias~d into the slots 180. The spring latches 188 include :8 curved spring arm~ 189 biased toward rearward edge~ o~ the slots :9 180 and roundsd b~ads 190 at upper ~nd~ of th~ spring arms 189 ~sr ~0 ~ngaging and securing th~ locking pin 178 in a locked posi~ion at 21 th~ uppermo8t ends o~ th~ ~lots 180. The bia~ing ~orce o~ the 22 spring ar~ 189 can be oYerCo~e by manually moving tha locking pin 23 178 ~rom the upp8rmo~t to the lowermo~t end~ o~ th~ ~lot~ 180.
24 A modi~lcation o~ th~ ~uction ~orc~ps according to the pres~nt in~ntion ~or u~ in grasping, rather than cutting, tis~ue is 26 acco~plished by sub~ uting gra~ping jaws ~or ~he cutting ~aws 24 1~ .

2 ~J 7 ~
1 an~ 26 at the distal end o~ pxobe 11 as illustrated in Fig. 7. The 2 grasping jaws include a stationary grasping jaw 224 mounted on the 3 distal end 14 of the outer probe member 12 and a movable grasping 4 jaw 226 mounted relative to the stationary grasping jaw 224 in the manner previously described in connection with the cutting jaws 24 6 and 26. The stationary grasping jaw ~24 has a tubular end 230 7 joined to distal end 14 o~ the outer member 12, a semi-c:ylindrical 8 wall 232 joined to a lower part o~ the tubular end 230 and an end 9 wall 234 that is arcuate in con~iguration when viewed ~rom above joined to the semi cylindrical wall 2320 A plurali~y o~ triangular 11 shaped grasping teeth 235 are dispoRed in longitudinal ali~nment on 12 opposing lateral ~ides of the semi~cylindrical wall 232, and a 13 chamber 240 is de~ined in the stationary grasping jaw 224 between 14 ths lateral sides of khe semi-cylindrical wall 232. The movable grasping jaw ~2~ includes a se~i-cylindrical top wall 248 joined to 16 an end wall 250 that i~ arcuate in configuration wh~n vi~wed ~rom 17 b~low and a plurality o~ triangular shaped grasping teeth 237 18 disposed in longitudinal alignm~nt on oppo~ing lateral sides o~ the 1~ semi~cylindrical wall 248 ~or coopera~iv~ interangagement with the 2G gra~ping teeth 235 to gra~p tissu~ when thQ movable grasping jaw 21 226 is pivot~d r~lative to ~a stationary grasping jaw 224 by the 22 ac~uator 76 and the ca~ 66 ~ransla~ing ~liding ~ovemant o~ the 23 inner me~b~r 18 in~o pivo~al ~ovam~n~ o~ ~h~ ~ovabl~ graspin7 jaw 24 226.

~I J~ ~
1 A modification of the suction cutting ~orceps according to the 2 present invention for backbiting or rearwardly directed cutting is 3 illustrated in Fig. 9 and includes a stationary cutt~ng jaw 324 and 4 a movable cutting jaw 326 dispo~ed on the distal end o~ probe 11 in place o~ jaws 24 and 26. The stationary cutting jaw 324 has a 6 tubular ~nd 330 joined to th~ open distal end of the outer probe 7 member, a rounded forward nose 331 joined tangentially to an upper 8 part of the tubular end 330 by a semi-cylindrical upper wall 333 9 and angularly to a lower part o~ the tubular end 330 by a semi-cylindrical lower wall 335. An opening 338 is formed in the bottom 11 of ths lower wall 335 to de~ine a cutting edge on tha inner surface 12 thereo~ includin~ a proximal portion 339~ and the opening 338 leads 13 into a chamber 3~0 in tha 3tationary cutting jaw 324 communicating 14 with the apertur~ 372 in the cam 366 mounted on tha op~n distal end o~ th~ inner probe member and having a distal wall 341 an~ a 16 proximal wall 343. An aperture 344 is formed through a top of the 17 upp~r wall 333 ln communication with thQ chamber 340 and angularly 18 o~se~ from the opening 338. The movabl~ cu~ing jaw 326 includes 19 a curved wall 348 joined to a end wall 350 that i arcuate in con~iguration and ~idQ walls 352 joined to th~ and wall 350 and the 21 top wall 348. A pivot pin 327 extend~ through th~ stationary jaw 22 324 and ~h~ ~id~ wall~ 352 o~ ~he movabl~ ~w trans~er~e to the 23 longitudinal axis o~ th~ inner member 18 to pivotally mount the 24 movabla jaw 326 on th~ stationa~y ~aw 324 at a pivot point di~posed distally o~ tha proximal cutting ~dg~ portion 339 o~ op~ning 3~.
26 An ~rcuate cutting ~dgQ 354 i3 ~o~med on ths end wall 350, and 7 ~ ~
ardly curving side cutting edges 35~ are formed on the side 2 walls 3S2 for movement pa~t the cu~ting edge on the inner surface 3 of the stationary cutting jaw 324. A recess is formed in -he 4 proximal end of the movable jaw 326 and extends laterally between the side walls 352 such that the side walls 352 define spaced, 6 parallel ears 360. The end of the actuator is positioned between 7 the ear~ 360 to align tha bore in the end with a bore extending 8 transversely through the ears 360, and a pivot pin 364 ls inserted 9 through the aligned bores to pivotally connect the actuator with the movable cutting jaw 326 while a pivot pin 329 pivotally mounts 11 th~ cam end of th~ actuator bQtween th~ ear~ o~ ~he ca~ 366. Flats 12 345 are formed on the prongs 360 alony a proximal ~nd wall of the 13 moYabl~ jaw 326.
14 In operation, the prob~ 11 having ~w~ appropriatQ for the procedure to be per orm~d, ~or exa~ple cutting jaws 24 and 26, is 16 insarted at a surgical si~, uch a~ through a ~mall portal in 17 endoscopic ~urgery. Th~ ~ubular exten~ion 124 on the suction 18 fitting 122 is connected to a vacuum source to produce suction 19 through th~ lumen o~ the shaft '20, and the ~uction i5 bypassed ~rom th~ jaw~ 24 and 26 due to the push ring 142 b~ing biased by 21 the suction ~pring 148 to uncover the suc~ion diverting holes 14Q
22 communicatlng wi~h the wind~w 100 and th~ pQrt 104 in the handle 23 body 28 a~ ~hown in Fig. 8. Accordingly, th~ suction forceps can 24 ba in~roduc~d easily in~o the surglcal si~ with no suct~on a~ the ~aw3. WhQn i~ i~ d~sir~d to cut ~isRu~ at ~he ~urgic21 ~itP, the 2~7~
1 o~ra~ing handlPs 98 and 150 are manually grasped and squeezed by 2 the surgeon causing the movable handle 150 to pivot, or rotate, 3 around the pivot pin 158. As the hand grip 152 on the movable 4 handle 150 is rotated toward the fixed handle 98, the ~ingers 162 on the actuating end 154 move in the distal direction against the 6 rearward shoulder 146 o~ the push ring 142 to overcome the biasing 7 force of the suction ~pring 148 and slide ths push ring 142 in the 3 distal direction relative to the shaft 120. Rokation of the 9 movable handl~ 150 approximately one-hal~ the ~ull rotational axtent o~ the handle 150 causes the suction spring 148 to be 11 compre~Qd between ~he clip 12B and the forward shoulder 144 o~ the lZ push ring 142 and the push ring 142 to be moved into a po~ition 13 covering the suction diverting hole~ 140 to produc~ su tion in the 14 suction passage defined by thQ lumen~ o~ th~ ~ha~t 120, the inner m~mb~r 18 and th~ cam 66 to establich ~uction in the chamber 40 via 16 the aperturQ 72 in the cam 660 WhilQ in an op~n po~ition, th3 jaws 17 24 and 26 are position~d to ~ngaga tissu~, and ths suction draws 1~ th~ tissue be~ween tha jaws ~4 and 26. The aperture 72 being 19 prsximally ~pac~d ~rom th~ jaw~ 24 and 26 produc~ a distribution of ~uction around th~ iaws 24 and 26 such that ti~5U8 i~ drawn 21 through th~ openlng 38 i~o th~ chamber 40 to be optimally 22 po~ition~d rQr pr~cision cutting. Further rotation o~ th~ ~ovable ~3 handla 150 cau~a~ ths ~ingers 162 acting against thQ push ring 142 24 to overcom~ tha ~iasing ~orce o~ th~ actuatlng spring 132 ~gainst tha clip 12a and slldQ th8 shaft 120 in thQ distal dir-ction within 26 the upper pa~sage 92. The shat 120 slides ~he inner me~ber 18 ~0 ~ ~ 7 ~
1 and, therefore, the cam ~6, in the distal direction relative to the 2 outar member 12 causing the actuator 76 to pivot, or rotate, the 3 movable jaw 2~ downwardly in a forward, or distal, direction 4 through the opening 38 to position the distal end wall 50 adjacent the distal end of the op~ning 58 and move the cutting edges 54 and 6 56 on the movable jaw 26 past the cutting edge on th~ inner surface 7 of the stationary jaw 24 to a closed po~ition to cut tissue through 8 the opening 58. The cut tissue i~ aspirated from the chamber 40 9 through the suction passage ko exit the suction ~orceps via the suction fitting 122, th~ suction pa~age having no con~trictions 11 therein to ob~truct tissue flow. When tha jaws 24 and 26 are in 12 the closed position, suction is still produce~ at the surgical sita 13 continuously via the ap~rture 44 in the stationary jaw 24 to 14 facilitata movQment o~ cut tis~ue throuyh the instrum~nt. When the handles 98 and 150 are released, the actuating spring 132 moves the 16 sha~t 120 in the proximal direction such that the ~top 134 on the 17 sha~t 120 ~but~ th~ washer 138 adjacent thQ suction fitting 122, 18 the movemen~ of the tubular shaf~ 120 cau~ing the a~uator 76 to 19 pivot the movabl~ jaw 26 to the open position a~ shown in Fig. 4.
Tho suction spring 148 moves the pu~h ring 142 in th2 proximal 21 direction to uncov~r th~ suc~ion diverting holes 140 and urge the 22 ~inger~ 162 o~ th~ movabl~ handl~ 150 against th~ stop 134.
23 For s~ty in handling and ~o ra~ilitate manipulation duriny 24 ins~rtion and positioning at a ~urgical ~it~, th~ ~aw~ 24 and 26 aan ~e lockad in th~ closed po~ition by manually holding thQ handle 26 150 in a rotated po~ition corr~sponding ~o the cloæed po~i~ion ~or 2~

..

2 ~ 8 1 the jaws 24 and 26 while manually moving the locking pin 178 via 2 ~he end caps 1~2 from the unlocked po~ition at the lowermost ends 3 of the slots 180 to the locked position at the uppermost ends of 4 the slots 180, wherein the locking pin 178 is retained by the beads 190 on the spring latches 188 to be secured against accidental 6 displacement ~rom thQ locked position. When the handle 150 is then 7 released, the lock~ng pin 178 engage~ tip 186 on the plunger 184 a and prevent~ the movable handle 150 ~rom automatically returning to ~ a position corresponding to the open position for the jaws 24 and iO 26 as shown in Fig. 3. The jaws 24 and 26 ara therea~ter opened by :1 ~anually grasping the end caps 182 and moving the locking pin 178 12 to the lowermo~t ends of the slots 180, such movement being 13 permitted by temporary deflection of the spring latche~ 188 14 outwardly from the 310~s 180 ~o permit the ~ovable handle 150 to auto~atically return to a po~ition corresponding to the open '6 position ~or the jaws 24 and 26 under the bias force of the ~7 actuating spriny 1 2. The tip 1~6 on the plunger 184 is ~hen '8 di~posQ~ in ~ha path o~ movemenk o~ the locking pin 178 and 19 prevant~ movement o~ the locking pin 178 to th~ locked po~ition 0 when the movabl~ handl~ 150 i3 no~ in a rotated position 21 corresponding to th~ closed~position ~or the jaw~ 24 and 26.
22 When an oparating ~orcQ i~ applied to th~ movabla handla 150 23 ~xceeding a pred~tarmined ~orce dRt~rmined by thQ forcs diverting 24 ~echani~m coop~r~ting with spring~ 172 and 177, ~uch as when attempting ~o GUt ve~y large quantitie~ of or ~ery hard tissue 26 between the ~aw~ 24 and 26, at lea~t a portion o~ t~ force is ;
~2 1 dlvertPd against the biasing force of the springs to move the pivot 2 pin 158 a tactile indica~ion to the surgeon o~ the excessive force 3 being applied such that the applied forc~ can be reduced without 4 damage to or breakage of components at the distal end of th~
forceps. The elbow 153 of the movable handle 150 move~ away from 6 the forward wall o~ the vertical passage 96 in opposition to the 7 overload spring 172, and the pivot pin 158 moves with the handle 8 150. The handl~ 150, thus, pivots around a second pivot point, and 9 the projecting ends o~ the pivot shaft 158 move visibly from the ~orwardmost end~ of the track3 160 toward th~ rearwardmo~t ends o~
11 the track~. By placing a f inger again t thQ tracks 160, a surgeon 12 can also fe~l the end~ of the pivot pin 158 moving within the 13 tracks. The tension or resistance ~el~ on th~ handle 150 and the 14 movement of the pivot pin 158 tactilely and visually indicate when a potentially da~aging operating force i~ applied through the lG handl~ lS0 and permit the operator to "eas2 of~" on the handle 150 17 and take a small~r "bito" of tissue prior to the suction forceps 18 being da~aged or disabled. Once the operating ~orcQ applied to the 19 msvabl~ handle 150 fall~ below th~ pr~deter~ined force, the overload spring 172 automatically positions thQ elbow 153 to engage 21 th~ forward wall o~ the vert~al pas~age 96 and th~ pivot shaft 158 22 at th~ ~orwardmo~t end~ of th~ track3 160. Th~ compressor 174 can 23 be position~d a select~d longitudinal distance in th~ lower passage 24 94 to obtain a de~ired tats o~ compre~ion ~or th~ ov~rload ~pring 172 tO therebY 8e1QCti~e1Y adju3t the magn~tude o~ the oparating 26 ~orca that can be applied via the handl~ 150 be~ore the 1 edetermined ~orce is reached. Additionally, it will be 2 appr~ciated th~t excessive force applied to the handles is taken up 3 or diverted by mov~ment o~ the piv~ pin 15~ against the spring 4 bias rather than being ~ransmitted to the jaws. In this manner, the jaws are protected eliminating the possibility of breakage at 6 the distal end of the suction foroeps in the surgical site.
7 The suction grasping forceps o~ Fiy. 7 is op~rated in the same 8 manner as previou~ly described with the jaw~ 224 and 22~ being 9 utilized to grasp tissue. Suction produced in the chamb~r 240 in the stationary jaw 224 initially draws tissue between the jaws 224 11 and 226 when thQ jaw~ aro in the open po~ition such that ti~sue 12 proximate but in less than dir~ct engagement with the ~aws 224 and 13 226 can be drawn into the chamber 240. The suction assists in 14 po~itioning and holding tha ti~ue between the jaws 224 and 226 when the jaws are clos2d around th~ ti3sue to facilitate use of the 16 jaw~ and permit the ti~sue to be pulled upon and manipulated with 17 the jaw~.
18 The suction outting ~orc~p~ of Fig. 9 i operated in the same 19 ~annQr a~ previou~ly de~cribed; howevcr, with the ~haft 120 biased again~t the suction ~itting 122 by th~ actuating spring 132, the 21 actuator 76 i~ po~ition~d c~trally in the chamber 340 between the 22 di~tal wall 341 and the proximal wall 343. The pivot pins 329 and 23 364 are substantially longitud~nally aligned, and the cutting 24 portion o~ th~ mov~ble ~aw 326 extend~ downwardly through the openin~ 338 and proximally ~ro~ the pivot poin~ 327 such ~hat the 26 cu~tlng edge~ 354 and 3~6 ~ace in a proximal, or rearward, ~7~
1 d~Lection as shown in Fig. 9. When the tubular shaft 120 and, 2 therefore, the inner member 18, are slid in the distal direction, 3 the actuator 37~ is moved ~orwardly by the cam 366, and the movable 4 cutting jaw 326 is pivoted by the actuator to position th2 flats 345 on the actuating portion of the movable jaw 326 in to 6 engagement with the distal wall 341 of the chamber 340 and the end 7 wall 350 of the movable jaw 326 in engagement with the proximal 8 cutting edge 339 as the cutting edges 354 and 356 mo~e upwardly 9 . through the opening 338 into the chamber 340. Therefore, the movable jaw 326 can b~ positioned ov~r and forwardly of tissue to 11 be cut and then pivoted or rotated in a proximal, or rearward, 12 direction to grab and scoop up the ti ~u~ into the opening 338 for 13 c~tting when the cutting edges 354 and 356 on the movabl~ jaw 326 14 move pa~t the opening 338 in a rearwardly directed "backbiting"
cutting action. Suction i produced at the surgical site 16 continuou~ly with ~uction producad at the jaws via the aperture 344 17 in the stationary jaw 324.
18 Having dQ~crib2d pr~fsrred and alternative e~bodiments of a 19 new and improved ~uction forcsp~, it is ~eliavzd that other ~0 modi~ications, varia~ion~ and chang~s will bQ sugges~ed to those 21 skilled in th~ art in Vi8W q~ th~ teaching~ ~et forth her~in. it 22 i there~or~ to ba understood that all such variation~, 23 modification~ and change~ ar~ beli~vad to ~all with th~ scop~ of 24 the prQsent lnv~ntion as de~in~d by the app~nd~d claims.

Claims

WHAT IS CLAIMED IS:

1. A surgical forceps for engaging tissue in the body comprising an elongate probe including an outer tubular member having a proximal end and a distal end and an inner member movable within said outer probe member and having a proximal end and a distal end;
jaw means for engaging tissue including a first jaw coupled with said outer probe member distal end and a second jaw coupled with said inner probe member distal end and mounted for pivotal movement relative to said first jaw in response to movement of said inner probe member within said outer probe member;
handle means coupled with said outer probe member proximal end and said inner probe member proximal end for moving said inner probe member relative to said outer probe member and pivoting said second jaw relative to said first jaw, said handle means including hand grip members squeezable to impart a force to pivot said first jaw via movement of said inner probe member; and force diverting means coupled with said handle means for diverting at least a portion of a force applied to said grip members from said jaw means when the applied force exceeds a predetermined force.

2. A surgical forceps as recited in claim 1 wherein said force diverting means is coupled with said grip members for providing a tactile indication of the applied force exceeding said predetermined force via said grip members.

3. A surgical forceps as recited in claim 2 wherein one of said grip members is mounted to pivot about a pivot pin and said force diverting means includes means biasing said pivot pin away from said other grip member with a force corresponding to said predetermined force and permitting said pivot pin to move against said bias means when the applied force exceeds said predetermined force.

4. A surgical forceps as recited in claim 3 wherein said handle means includes means for permitting visualization of movement of said pivot pin.

5. A surgical forceps as recited in claim 1 wherein said handle means include movable pivot means for pivotally mounting one of said grip members and means for movably supporting said pivot means, said pivot means being movable when the applied force exceeds said predetermined force.

6. A surgical forceps as recited in claim 5 wherein said handle means includes a body mounting said grip members, said supporting means includes slots in said body, and said pivot means includes a pivot pin having opposing ends movably received in said slots.

7. A surgical forceps as recited in claim 6 wherein said body includes spaced parallel walls and said slots are formed in said walls.

8. A surgical forceps as recited in claim 7 wherein said force diverting means includes means for biasing said pivot pin against movement in said slots when the applied force is less than said predetermined force and permitting movement of said pivot pin in said slots when the applied force exceeds said predetermined force.

9. A surgical forceps as recited in claim 8 wherein said body includes an upper passage between said side walls and a lower passage between said side walls in parallel with said upper passage, said handle means includes actuating means connecting said one grip member with said inner probe member proximal end and disposed in said upper passage, said bias means is disposed in said lower passage, said pivot pin is disposed in said body in longitudinal alignment with said lower passage, and said force diverting means includes means for holding said pivot pin in engagement with said bias means including a disk disposed in said lower passage in engagement with said bias means and a projection on said disk having a notch therein for retaining said pivot pin.

10. A surgical forceps as recited in claim 9 wherein said bias means includes a helical spring mounted in compression in said lower passage and means for selectively compressing said spring against said holding means.

11. A surgical forceps as recited in claim 1 wherein said first and second jaws have peripheral cutting edges for severing tissue, said inner probe member is tubular, and said handle means has a passage therethrough terminating at a suction fitting, said inner probe member and said handle means passage forming a suction passage for aspirating cut tissue through said surgical forceps.

12. A surgical forceps as recited in claim 1 wherein said first and second jaws carry cooperatively interengagable grasping teeth for holding tissue therebetween, said inner probe member is tubular, and said handle means has a passage therethrough terminating at a suction fitting, said inner probe member and said handle means passage forming a suction passage for assisting grasping of tissue between said first and second jaws.

13. A surgical forceps for engaging tissue in the body comprising an elongate probe having a distal end and a proximal end;
jaw means mounted on said probe distal end for movement between an open position and a closed position to engage tissue;
handle means coupled with said probe proximal end including hand grip members movable relative to each other for moving said jaw means between said open and closed positions; and locking means carried by said handle means for locking said jaw means in said closed position, said locking means being movable to a locked position engaging one of said grip members only when said jaw means is in said closed position.

14. A surgical forceps as recited in claim 13 wherein said handle means includes means for preventing movement of said locking mean to said locked position when said jaw means is not in said closed position.

15. A surgical forceps as recited in claim 14 wherein said handle means includes latch means for securing said locking means in said locked position.

16. A surgical forceps as recited in claim 15 wherein said handle means includes track means and aid locking means includes a pin having opposing ends movably received in said track means.

17. A surgical forceps as recited in claim 15 wherein said handle means includes a body with said track means formed therein, and said latch means includes spring arms formed integral with said body along said track means.

18. A suction forceps for cutting tissue in the body and aspirating the cut tissue comprising an elongate probe including an outer tubular member having a proximal end and a distal end and an inner tubular member axially slidable in said outer probe member and having a proximal end and a distal end, a stationary jaw mounted on said outer probe member distal end and having an opening therein with at least a proximal portion of said opening forming a cutting edge:
a movable jaw pivotally mounted on said stationary jaw at a pivot point disposed distally of said proximal cutting edge portion, said movable jaw being movable between closed and open positions and having a cutting portion extending proximally from said pivot point when said movable jaw is in said closed position adjacent said cutting edge and an actuating portion connected with said inner probe member distal end and extending distally from said pivot point when said movable jaw is in said closed position;
handle means receiving said proximal ends of said inner and outer probe member and including a first hand grip member connected with said inner probe member proximal end and a second hand grip member connected with said outer probe member proximal end, said first and second grip members being squeezable to move said inner probe member within said outer probe member to move said movable jaw between said open and closed positions to cut tissue, and suction passage means for aspirating cut tissue formed of the lumen in said inner probe member and a passage in said handle means terminating at a suction fitting.

19. A suction forceps as recited in claim 18 and further comprising force diverting means coupled with said grip members for diverting at least a portion of a force applied to said grip members from said jaws when the applied force exceeds a predetermined force and for providing a tactile indication via said grip members of the applied force exceeding said predetermined force.

20. A suction forceps as recited in claim 19 wherein said handle mean includes means for locking said movable jaw in said closed position.

21. A suction forceps for cutting tissue in the body and aspirating the cut tissue comprising an elongate probe including an outer tubular member having a proximal end and a distal end and an inner tubular member axially slidable in said outer probe member and having an open proximal end and an open distal end;
a stationary jaw mounted on said outer probe member distal end and having a first opening in one side thereof with at least a distal portion of said opening forming a cutting edge and a second opening disposed in a side opposing said one side, the first and second openings defining a chamber therebetween;
a movable jaw pivotally mounted on said stationary jaw at a pivot point disposed proximally of said second opening, said movable jaw being movable between closed and open positions and having a cutting portion extending distally from said pivot point when said movable jaw is in said closed position adjacent said cutting edge and an actuating portion connected with said inner probe member distal end and extending proximally from said pivot point when said movable jaw is in said closed position;
handle means receiving said proximal ends of said inner and outer probe members and including a first hand grip member connected with said inner probe member proximal end and a second hand grip member connected with said outer probe member proximal end, said first and second grip members being squeezable to move said inner probe member within said outer probe member to move said movable jaw between aid open and closed positions to cut tissue;
and suction passage means for aspirating cut tissue formed of said second opening and said chamber in said stationary jaw, said open distal end and the lumen in said inner probe member and a passage in said handle means communicating with said open proximal end of said inner probe member terminating at a suction fitting.

22. A suction forceps as recited in claim 21 and further comprising force diverting means coupled with said grip members for diverting at least a portion of a force applied to said grip members from said jaws when the applied force exceeds a predetermined force and for providing a tactile indication via said grip members of the applied force exceeding said predetermined force.

23. A suction forceps as recited in claim 22 wherein said handle means includes means for locking said movable jaw in said closed position.

24. A suction forceps for cutting tissue in the body and aspirating the cut tissue comprising an elongate probe including an outer tubular member having a proximal end and a distal end and an inner tubular member axially slidable in said outer probe member and having an open proximal end and an open distal end;
a stationary jaw mounted on said outer probe member distal end and having an opening therein forming a cutting edge;
a movable jaw pivotally mounted on said stationary jaw and having a cutting edge cooperating with said stationary jaw cutting edge to cut tissue therebetween;
handle means receiving said proximal ends of said inner and outer probe members and including a first hand grip member connected with said inner probe member proximal end and a second nd grip member connected with said outer probe member proximal end, said first and second grip members being sqeezable to move said inner probe member within said outer probe member to move said movable jaw;
suction passage means for aspirating cut tissue from said jaws through said probe and said handle means; and suction control means responsive to squeezing movement of said grip members to selectively control suction at said jaws.