CN1889890A - 具有增益台阶的超声手术刀和器械 - Google Patents

具有增益台阶的超声手术刀和器械 Download PDF

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CN1889890A
CN1889890A CNA2004800364318A CN200480036431A CN1889890A CN 1889890 A CN1889890 A CN 1889890A CN A2004800364318 A CNA2004800364318 A CN A2004800364318A CN 200480036431 A CN200480036431 A CN 200480036431A CN 1889890 A CN1889890 A CN 1889890A
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surgical blade
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福斯特·B·斯塔伦
史蒂文·K·纽恩费尔特
凯文·L·豪泽
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Ethicon Endo Surgery Inc
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Abstract

一种具有增益台阶的超声手术刀和器械。在超声手术刀主体的任何半波长中，刀主体具有第一振动波腹、振动波节、第二振动波腹和增益台阶。所述增益台阶位于第二振动波腹和第一振动波腹之间。所述增益台阶与所述振动波节间隔一增益台阶距离，该增益台阶距离大于在第二振动波腹和第一振动波腹之间的距离的5％。所述器械包括所述刀、具有超声换能器的手持件和超声传输杆，该超声传输杆的近端可操作地连接到所述超声换能器，超声传输杆的远端致动所述刀。在一个选择中，第一振动波腹是远侧末端，增益台阶位于振动波节和远侧末端之间，从而导致刀有效长度的增加。

Description

具有增益台阶的超声手术刀和器械
技术领域
本发明总的涉及超声手术刀(blade)和包括超声手术刀的超声手术器械，尤其涉及具有增益台阶的超声手术刀和超声手术器械。
背景技术
已知的超声手术器械包括超声手术刀。已知的超声手术器械的手持件包括超声换能器，该超声换能器由超声发生器通过电缆提供动力。所述器械的超声传输杆具有近端和远端，其中近端可操作地连接到超声换能器。超声手术刀由超声传输杆的远端致动。已知的刀形状包括直刀和弯曲刀，并且包括关于纵向轴线或关于刀的弯曲中心线对称和不对称的刀。
已知的超声手术刀是圆柱形刀，其具有远侧末端、最远侧振动波节(振动波节是基本上零位移的点)和第二最远侧振动波腹(振动波腹是相对于半波中所有其它点的最大位移的点)，其中最远侧振动波腹是远侧末端。刀的纵向超声振动在所接触的组织中产生运动和热量，其中热量主要提供刀切割和/或凝固患者组织的手段。该刀具有位于离最远侧振动波节一段距离的增益台阶，由于使增益台阶靠近最远侧振动波节定位使振幅增益最大化，因此所述距离小于在远侧末端和第二最远侧振动波腹之间的距离的5％。已知的刀包括从第二最远侧振动波腹到最远侧振动波节的较大直径的几何正圆柱体。已知的刀包括从最远侧振动波节到远侧末端的较小直径的几何正圆柱体。直径的变化为刀的较小直径截面提供了振幅的增益，当增益台阶位于波节处时，所述振幅增益等于较大直径刀截面与较小直径刀截面的横截面积的比。
超声手术刀的有效长度由申请人定义为从远侧末端到振幅(即纵向振幅)下降到末端的幅值的50％的距离。刀在其有效长度之外被认为是无用的。在大约55.5kHz的共振频率下直圆柱钛杆的有效长度大约为15mm。
在塑料的超声焊接中已知的是提供一种具有增益台阶的超声焊条，所述增益台阶例如为较大和较小焊条直径之间的不连续，该增益台阶位于焊头(welding horn)的最远侧振动波节和远端之间，并且与焊条的最远侧振动波节间隔一段距离，该距离小于焊条的第二最远侧振动波腹和远端之间的距离的5％。在塑料的超声焊接中还已知的是提供一种带有孔或狭槽的超声焊条，以提供纵向振幅的增益。
所需的是一种改进的超声手术刀以及一种改进的超声手术器械，该器械包括具有较长或较短的有效长度的超声手术刀。
发明内容
本发明的实施方案的第一种表现方式是包括超声手术刀主体的超声手术刀。所述超声手术刀主体具有作为最远侧振动波腹的远侧末端、具有最远侧振动波节、具有第二最远侧振动波腹并且具有增益台阶。所述增益台阶位于第二最远侧振动波腹和远侧末端之间，并且所述增益台阶与最远侧振动波节间隔一增益台阶距离，该增益台阶距离大于在第二最远侧振动波腹和远侧末端之间的距离的5％。
本发明的实施方案的第二种表现方式是一种超声手术器械，该超声手术器械包括手持件、超声传输杆和超声手术刀。所述手持件包括超声换能器。所述超声传输杆具有近端和远端，其中所述近端可操作地连接到所述超声换能器。所述超声手术刀由所述远端致动并且包括超声手术刀主体。所述超声手术刀主体具有作为最远侧振动波腹的远侧末端、具有最远侧振动波节、具有第二最远侧振动波腹并且具有增益台阶。所述增益台阶位于第二最远侧振动波腹和远侧末端之间，并且所述增益台阶与最远侧振动波节间隔一增益台阶距离，该增益台阶距离大于在第二最远侧振动波腹和远侧末端之间的距离的5％。
本发明的实施方案的第三种表现方式是包括超声手术刀主体的超声手术刀。在所述超声手术刀主体的任何半波长中，所述超声手术刀主体具有第一振动波腹、振动波节、第二振动波腹和增益台阶。所述增益台阶位于第二振动波腹和第一振动波腹之间。所述增益台阶与所述振动波节间隔一增益台阶距离，该增益台阶距离大于在第二振动波腹和第一振动波腹之间的距离的5％。
从本发明的实施方案的一个或多个表现方式可以获得若干益处和优点。申请人发现，与传统上所教导的相比，使具有大于单位增益的增益的增益台阶(即放大台阶)定位成朝着远侧末端更远离最远侧振动波节可进一步增加超声手术刀的有效长度，即使振幅增益小于在传统上使增益台阶定位成更靠近最远侧振动波节的时候。申请人确定，与传统上所教导的相比，使增益台阶定位成朝着第二最远侧振动波腹更远离最远侧振动波节将缩短超声手术刀的半波长。申请人还确定，超声手术刀的有效和半波长的这种变化还由具有小于单位增益的增益的增益台阶(即衰减台阶)产生，但是若衰减台阶导致有效长度的减小，相同位置的放大台阶将导致有效长度的增加，若衰减台阶导致有效长度的增加，相同位置的放大台阶将导致有效长度的减小。本领域的技术人员可以理解，能够加长或缩短超声手术刀的有效长度为特定手术应用提供了优点。
本发明并不受到限定，可应用于机器人辅助手术。
附图说明
图1是一种超声手术器械的第一实施方案的示意图，该超声手术器械包括本发明的超声手术刀的第一实施方案；
图2是图1的超声手术刀的包括远侧末端的最远侧半波长的纵向剖视图；
图3是图1的手术刀的第二实施方案的包括远侧末端的最远侧半波长的纵向剖视图；和
图4是图1的手术刀的第三实施方案的包括远侧末端的最远侧半波长的纵向剖视图。
具体实施方式
在具体解释本发明之前，应当注意的是，本发明并不局限于在附图和说明书中所例举之部件的构造和布置的细节的应用或使用。本发明的示例性实施例可以在其它实施例、变化和改进中被实现或被结合，并且可以以各种方式实施或执行。此外，除非另外指出，在此使用的术语和表达被选择成为了方便读者而描述本发明的示例性实施例，并不是为了限定本发明。
应当理解，一个实施方案、多个实施例等的一个或多个下述表现方式可以与一个实施方案、多个实施例等的一个或多个其它下述表现方式结合。例如(而非限定性地)减小半径的增益特征可以与孔的增益特征结合。
现在参考附图，图1-2示出了本发明的第一实施方案。图1-2的第一实施方案的第一种表现方式是包括超声手术刀主体12的超声手术刀10，所述超声手术刀主体具有作为最远侧振动波腹(振动波腹是相对于半波中所有其它点的最大位移的点)的远侧末端14、具有最远侧振动波节16(振动波节是基本上零位移的点)、具有第二最远侧振动波腹18并且具有增益台阶20。增益台阶20被布置在第二最远侧振动波腹18和远侧末端14之间，并且与最远侧振动波节16间隔增益台阶距离22，该增益台阶距离大于在第二最远侧振动波腹18和远侧末端14之间的距离24的5％。
在图1-2的第一实施方案的第一种表现方式的一个实施中，增益台阶距离22在第二最远侧振动波腹18和远侧末端14之间的距离24的大致25％至大致45％之间。利用本发明对增益台阶20的位置的教导，本领域的普通技术人员可以建立解析刀模型并且使用计算机程序评估它们，以优化超声手术刀的增加或减小有效长度与纵向超声振动的增加或减小幅度之间的设计权衡，以用于将增益台阶20定位成沿远侧末端14的方向或沿第二最远侧振动波腹18的方向基本上离开最远侧振动波节16。
在图1-2的第一实施方案的第一种表现方式的一个例子中，在第二最远侧振动波腹18和远侧末端14之间，超声手术刀主体12在增益台阶20近侧的最大振幅小于超声手术刀主体12在增益台阶20远侧的最大振幅。在该例子中，增益台阶20的增益大于单位增益，并且是由于超声手术刀主体12在增益台阶20和远侧末端14之间的质量比超声手术刀主体12在增益台阶20和第二最远侧振动波腹18之间的质量小而产生。
在未示出的不同实施方案中，在第二最远侧振动波腹和远侧末端之间，超声手术刀主体在增益台阶近侧的最大振幅大于超声手术刀主体在增益台阶远侧的最大振幅。在该实施方案中，增益台阶的增益小于单位增益，并且是由于超声手术刀主体在增益台阶和远侧末端之间的质量比超声手术刀主体在增益台阶和第二最远侧振动波腹之间的质量大而产生。在一个实施例中，该实施方案可以通过切换图2中远侧末端14和第二最远侧振动波腹18的位置而容易地设想出。
在图1-2的第一实施方案的第一种表现方式的一个实现中，增益台阶20被布置在最远侧振动波节16和远侧末端14之间，从而导致超声手术刀10的有效长度增加。在未示出的不同实施方案中，增益台阶被布置在最远侧振动波节和第二最远侧振动波腹之间，从而导致超声手术刀的半波长减小。该实施方案可以通过在图2中的最远侧振动波节16和第二最远侧振动波腹18之间移动增益台阶20而容易地设想出。
在图1-2的第一实施方案的第一种表现方式的一个示例中，超声手术刀主体12具有纵向轴线26并且基本上由第一几何实体28和第二几何实体30组成，第一几何实体28具有从增益台阶20到远侧末端14的基本恒定的第一横截面积，第二几何实体30具有从增益台阶20到第二最远侧振动波腹18的基本恒定的第二横截面积。第二横截面积不同于第一横截面积。在一个变化中，第一横截面积的第一外周界的形状和尺寸基本上等于第二横截面积的第二外周界的形状和尺寸。在一个变型中，第一和第二横截面积中的至少一个包围一个内腔32。在一个构造中，内腔32包括第一纵向孔34，该第一纵向孔被布置在第一几何实体28中并且从远侧末端14朝近端延伸。申请人发现，将增益台阶20定位在增益等于第二几何实体30与第一几何实体28的横截面积之比的平方根的位置处可优化刀有效长度的增加。在一个布置中，内腔32包括第二纵向孔36，该第二纵向孔被布置在第二几何实体30中并且与第一纵向孔34流体连通，第一和第二纵向孔34和36适于灌注和/或抽吸。在另一布置中，超声手术刀10还包括膜38，该膜的成分基本上与超声手术刀主体12的成分相同，该膜覆盖着第一纵向孔34，并且在远侧末端14可移除地或永久性地附着到第一几何实体28上。应当注意的是，当需要灌注和/或抽吸时，膜38将从图2中的第一几何实体28上移除。作为另一选择，膜38可以由可渗透的织物(例如丝网或滤网)、或者由钛或其它合适的材料制造的烧结网格制造，以便于灌注和/或抽吸。
在末示出的不同实施方案中，超声手术刀主体具有纵向轴线并且基本上由第一几何实体和第二几何实体组成。第一几何实体具有第一质量，其从增益台阶延伸到远侧末端，并且具有不恒定的第一横截面积。第二几何实体具有第二质量，其从增益台阶延伸到第二最远侧振动波腹，并且具有不恒定的第二横截面积。第二质量不同于第一质量。在一个例子中，该实施方案通过在图2中考虑第二纵向孔36具有从第二最远侧振动波腹18向增益台阶20减小的直径、以及第一纵向孔34具有从增益台阶20向远侧末端14增加的直径而容易地设想出。前述段落的变型、改进等可等效地应用于该实施方案。
在未示出的另一实施方案中，超声手术刀主体具有纵向轴线并且基本上由第一几何实体和第二几何实体组成，该第一几何实体具有第一质量并且具有从增益台阶延伸到远侧末端的第一轴向长度，所述第二几何实体具有第二质量并且具有从增益台阶延伸到第二最远侧振动波腹的第二轴向长度。第二质量不同于第一质量。第一和第二几何实体中的一个沿其相应的轴向长度具有基本上恒定的横截面积，第一和第二几何实体中的另一个沿其相应的轴向长度具有不恒定的横截面积。在一个例子中，该实施方案通过在图2中考虑第一纵向孔34具有从增益台阶20向远侧末端14增加的直径而容易地设想出。第二前述段落的变型、改进等可等效地应用于该实施方案。
在图1-2的第一实施方案的第一种表现方式的一个设计中，超声手术刀主体12具有纵向轴线26并且其关于纵向轴线26基本上对称。在未示出的另一设计中，超声手术刀主体具有纵向轴线、具有有效长度并且其关于纵向轴线沿至少一部分有效长度基本上不对称。在一个变型中，超声手术刀主体是弯曲的。在一个例子中，该变型通过在图2中从纵向轴线26向上弯曲超声手术刀主体12的远侧部分而容易地设想出。
在图1-2的第一实施方案的第一种表现方式的一个运用中，超声手术刀主体12具有选自下组的至少一个增益特征40，所述组包括：外径或周界的不连续变化、锥度、纵向孔、纵向孔直径的不连续变化、横向孔、表面平整度和表面狭槽。应当注意的是，在该运用中，增益台阶20是增益特征40的最靠近最远侧振动波节16的部分的位置。还应当注意的是，术语“孔”包括通孔和非通孔。其它增益特征可由技术人员设想。
图3示出了本发明的超声手术刀110的第二实施方案。在该实施方案中，超声手术刀主体112具有与增益台阶120间隔开的附加增益台阶142，该附加增益台阶被布置在第二最远侧振动波腹118和远侧末端114之间，并且与最远侧振动波节116间隔增益台阶距离122，该增益台阶距离大于在第二最远侧振动波腹118和远侧末端114之间的距离124的5％。超声手术刀主体112具有纵向轴线126和纵向孔134，其中纵向孔具有限定附加增益台阶142的肩部144。
超声手术刀210的第三实施方案在图4中示出，其中超声手术刀主体212基本上由从增益台阶220到远侧末端214的第一几何正圆柱体288组成。在该实施方案中，超声手术刀主体212基本上由从增益台阶220到第二最远侧振动波腹218的第二几何正圆柱体230组成。第一几何圆柱体288的直径小于第二几何圆柱体230的直径。应当注意的是，在该实施方案中，增益特征240是从远侧末端214到增益台阶220的减小直径，其减小质量并且产生了第一几何圆柱体288。增益台阶220被布置在第二最远侧振动波腹218和远侧末端214之间，并且与最远侧振动波节216间隔一增益台阶距离222，该增益台阶距离222大于在第二最远侧振动波腹218和远侧末端214之间的距离224的5％。
在图1-2的第一实施方案的第一种表现方式的一个构造中，超声手术刀主体12基本上由钛构成。在其它构造中，刀主体基本上可由铝、陶瓷、蓝宝石或以有效方式传输超声波的任何其它材料构成。使用本发明所述原理的各种钛刀设计的数学分析使超声手术刀10的有效长度获得高达40％的增加，其中所述原理要求将增益台阶20定位成沿远侧末端14的方向基本上远离最远侧振动波节16。申请人在理论上已发现高达60％的增加。如前面所述，超声手术刀10的有效长度被定义为从远侧末端14到振幅(即纵向振幅)下降到末端的幅度的50％处的距离。刀在其有效长度之外被认为是无用的。在不应用本发明的原理的情况中，在大约55.5kHz的共振频率下，直圆柱钛杆的有效长度大约为15mm。使用本发明的所述原理，当增益台阶20被布置在最远侧振动波节16和远侧末端14之间时，可以预期增加高达大约5mm的有效长度。
在一个布置中，超声手术刀10被单独用作超声手术器械的端部执行器。在另一布置中，超声手术刀10与夹钳臂(未示出)一起使用，以产生用于切割和/或凝固患者组织的超声手术器械的剪切端部执行器。
图1-2的第一实施方案的第二种表现方式用于一种超声手术器械46，该超声手术器械包括手持件48、超声传输杆50和超声手术刀10。手持件48包括超声换能器52。超声传输杆50具有近端和远端，其中近端可操作地连接到超声换能器52。超声手术刀10由远端致动并且包括超声手术刀主体12。超声手术刀主体12具有作为最远侧振动波腹的远侧末端14、具有最远侧振动波节16、具有第二最远侧振动波腹18并且具有增益台阶20。增益台阶20被布置在第二最远侧振动波腹18和远侧末端14之间，并且与最远侧振动波节16间隔一增益台阶距离22，该增益台阶距离22大于在第二最远侧振动波腹18和远侧末端14之间的距离24的5％。
在图1-2的第一实施方案的第二种表现方式的一个实现中，还包括由脚踏板56致动的超声发生器54、以及可操作地连接超声发生器54和手持件48的超声换能器52的电缆58。在一个构造中，超声手术刀10是超声传输杆50的整体组成部分。在另一构造中，超声手术刀是分离件，并且被连接到超声传输杆。应当注意的是，前述超声手术刀的实施方案、执行方式、例子、图解等可同样应用于超声手术器械。
图1-2的第一实施方案的第三种表现方式是一种超声手术刀，该超声手术刀包括超声手术刀主体，在该超声手术刀主体的任何半波长中，该超声手术刀主体具有第一振动波腹、振动波节、第二振动波腹和增益台阶，其中增益台阶被布置在第二振动波腹和第一振动波腹之间，并且其中增益台阶与振动波节间隔一增益台阶距离，该增益台阶距离大于在第二振动波腹和第一振动波腹之间的距离的5％。应当注意的是，第三种表现方式并不像前面提出的第二种表现方式那样将半波的位置限制在刀主体的最后半波长，并且除了半波的第二种表现方式的位置之外，前述第二种表现方式的实施方案、执行方式、例子、图解等可同样应用于第三种表现方式。
从本发明实施方案的一个或多个表现方式可以获得若干益处和优点。申请人发现，使具有大于单位增益的增益的增益台阶(即放大台阶)定位成朝着远侧末端比传统上所教导的更远离最远侧振动波节进一步增加了超声手术刀的有效长度，即使振幅增益小于在传统上使增益台阶定位成更靠近最远侧振动波节的时候。申请人确定，与传统上所教导的相比，使增益台阶定位成朝着第二最远侧振动波腹更远离最远侧振动波节将缩短超声手术刀的半波长。申请人还确定，超声手术刀的有效和半波长的这种变化也将由具有小于单位增益的增益的增益台阶(即衰减台阶)产生，但是若衰减台阶导致有效长度的减小，相同位置的放大台阶将导致有效长度的增加，若衰减台阶导致有效长度的增加，相同位置的放大台阶将导致有效长度的减小。本领域的技术人员可以理解，能够加长或缩短超声手术刀的有效长度为特定手术应用提供了优点。
为了举例目的已经示出了本发明的若干表现方式和实施方案的前述说明。这并不意味着是穷举的或者将本发明限制在所公开的精确形式，根据以上教导，许多改进和变型显然是可能的。例如，对于本领域的技术人员来说显而易见的是，考虑到与机器人系统兼容的这种系统、组成元件和方法的明显变型，在此公开的超声手术刀和超声手术器械可同样地应用于机器人辅助手术中。

Claims (26)

1.一种超声手术刀，其包括超声手术刀主体，该超声手术刀主体具有作为最远侧振动波腹的远侧末端、最远侧振动波节、第二最远侧振动波腹以及增益台阶，其中，所述增益台阶被布置在第二最远侧振动波腹和远侧末端之间，并且所述增益台阶与最远侧振动波节间隔一增益台阶距离，该增益台阶距离大于在第二最远侧振动波腹和远侧末端之间的距离的5％。
2.根据权利要求1所述的超声手术刀，其中，所述增益台阶距离在第二最远侧振动波腹和远侧末端之间的距离的大致25％至大致45％之间。
3.根据权利要求1所述的超声手术刀，其中，在第二最远侧振动波腹和远侧末端之间，超声手术刀主体在增益台阶近侧的最大振幅小于超声手术刀主体在增益台阶远侧的最大振幅。
4.根据权利要求1所述的超声手术刀，其中，在第二最远侧振动波腹和远侧末端之间，超声手术刀主体在增益台阶近侧的最大振幅大于超声手术刀主体在增益台阶远侧的最大振幅。
5.根据权利要求1所述的超声手术刀，其中，所述增益台阶被布置在最远侧振动波节和远侧末端之间。
6.根据权利要求1所述的超声手术刀，其中，所述增益台阶被布置在最远侧振动波节和第二最远侧振动波腹之间。
7.根据权利要求1所述的超声手术刀，其中，所述超声手术刀主体具有纵向轴线并且基本上由第一几何实体和第二几何实体组成，该第一几何实体具有从增益台阶到远侧末端的基本上恒定的第一横截面积，所述第二几何实体具有从增益台阶到第二最远侧振动波腹的基本上恒定的第二横截面积，其中第二横截面积与第一横截面积不同。
8.根据权利要求7所述的超声手术刀，其中，所述第一横截面积的第一外周界的形状和尺寸基本上等于所述第二横截面积的第二外周界的形状和尺寸。
9.根据权利要求8所述的超声手术刀，其中，所述第一和第二横截面积中的至少一个包围一内腔。
10.根据权利要求9所述的超声手术刀，其中，所述内腔包括第一纵向孔，该第一纵向孔被布置在第一几何实体中并且从远侧末端朝近侧延伸。
11.根据权利要求10所述的超声手术刀，其中，所述内腔包括第二纵向孔，该第二纵向孔被布置在第二几何实体中并且与第一纵向孔流体连通，且所述第一和第二纵向孔适于灌注和/或抽吸。
12.根据权利要求10所述的超声手术刀，还包括膜，该膜覆盖第一纵向孔并且在远侧末端处可移除地或永久性地附着到第一几何实体。
13.根据权利要求1所述的超声手术刀，其中，所述超声手术刀主体具有纵向轴线并且基本上由第一几何实体和第二几何实体构成，并且该第一几何实体具有第一质量、从增益台阶延伸到远侧末端并具有不恒定的第一横截面积，所述第二几何实体具有第二质量、从增益台阶延伸到第二最远侧振动波腹并具有不恒定的第二横截面积，其中第二质量不同于第一质量。
14.根据权利要求13所述的超声手术刀，其中，所述第一横截面积的第一外周界的形状和尺寸基本上等于第二横截面积的第二外周界的形状和尺寸。
15.根据权利要求14所述的超声手术刀，其中，所述第一和第二横截面积中的至少一个包围一内腔。
16.根据权利要求15所述的超声手术刀，其中，所述内腔包括第一纵向孔，该第一纵向孔被布置在第一几何实体中并且从远侧末端朝近侧延伸。
17.根据权利要求16所述的超声手术刀，其中，所述内腔包括第二纵向孔，该第二纵向孔被布置在第二几何实体中并且与第一纵向孔流体连通，且所述第一和第二纵向孔适于灌注和/或抽吸。
18.根据权利要求16所述的超声手术刀，还包括膜，该膜覆盖第一纵向孔并且在远侧末端处可移除地或永久性地附着到第一几何实体。
19.根据权利要求1所述的超声手术刀，其中，所述超声手术刀主体具有纵向轴线并且基本上由第一几何实体和第二几何实体构成，该第一几何实体具有第一质量并且具有从增益台阶延伸到远侧末端的第一轴向长度，该第二几何实体具有第二质量并且具有从增益台阶延伸到第二最远侧振动波腹的第二轴向长度，其中第二质量不同于第一质量，所述第一和第二几何实体中的一个沿其相应的轴向长度具有基本上恒定的横截面积，并且所述第一和第二几何实体中的另一个沿其相应的轴向长度具有不恒定的横截面积。
20.根据权利要求1所述的超声手术刀，其中，所述超声手术刀主体具有纵向轴线并且关于所述纵向轴线基本上对称。
21.根据权利要求1所述的超声手术刀，其中，所述超声手术刀主体具有纵向轴线、有效长度并且关于所述纵向轴线沿至少一部分有效长度基本上不对称。
22.根据权利要求21所述的超声手术刀，其中，所述超声手术刀主体是弯曲的。
23.根据权利要求1所述的超声手术刀，其中，所述超声手术刀主体具有选自下组的至少一个增益特征，所述组包括：外径或周界的不连续变化、锥度、纵向孔、纵向孔直径的不连续变化、横向孔、表面平整度和表面狭槽。
24.根据权利要求1所述的超声手术刀，其中，所述超声手术刀主体具有与增益台阶间隔开的附加增益台阶，该附加增益台阶被布置在第二最远侧振动波腹和远侧末端之间，并且其与最远侧振动波节间隔一增益台阶距离，该增益台阶距离大于在第二最远侧振动波腹和远侧末端之间的距离的5％，所述超声手术刀主体具有纵向轴线和纵向孔，其中纵向孔具有限定所述附加增益台阶的肩部。
25.一种超声手术器械，其包括：
a)包括超声换能器的手持件；
b)具有近端和远端的超声传输杆，其中所述近端可操作地连接到所述超声换能器；以及
c)超声手术刀，其由所述远端致动并且包括超声手术刀主体，该超声手术刀主体具有作为最远侧振动波腹的远侧末端、最远侧振动波节、第二最远侧振动波腹以及增益台阶，所述增益台阶被布置在第二最远侧振动波腹和远侧末端之间，并且所述增益台阶与最远侧振动波节间隔一增益台阶距离，该增益台阶距离大于在第二最远侧振动波腹和远侧末端之间的距离的5％。
26.一种超声手术刀，其包括超声手术刀主体，在所述超声手术刀主体的任何半波长中，所述超声手术刀主体具有第一振动波腹、振动波节、第二振动波腹和增益台阶，所述增益台阶被布置在第二振动波腹和第一振动波腹之间，并且所述增益台阶与所述振动波节间隔一增益台阶距离，该增益台阶距离大于在第二振动波腹和第一振动波腹之间的距离的5％。
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