US20190343549A1 - Ultrasonic surgical instrument - Google Patents
Ultrasonic surgical instrument Download PDFInfo
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- US20190343549A1 US20190343549A1 US16/520,064 US201916520064A US2019343549A1 US 20190343549 A1 US20190343549 A1 US 20190343549A1 US 201916520064 A US201916520064 A US 201916520064A US 2019343549 A1 US2019343549 A1 US 2019343549A1
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- Prior art keywords
- jaw member
- surgical instrument
- ultrasonic surgical
- aperture
- ultrasonic
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00353—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2944—Translation of jaw members
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320072—Working tips with special features, e.g. extending parts
- A61B2017/320078—Tissue manipulating surface
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320084—Irrigation sleeves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
Definitions
- the present disclosure relates to surgical instruments, and more particularly, to an ultrasonic surgical instrument
- Ultrasonic devices for surgical uses are well known. Ultrasonic devices convert electrical energy into high frequency mechanical impulses (ultrasonic waves) that are then used to treat tissue.
- ultrasonic aspirator typically includes a handpiece, an elongated probe, and a vibrating tip. Ultrasonic waves emanating from the vibrating tip treat tissue with high water content (e.g., tumors, liver parenchyma) while tissue with low water content (e.g., nerves, vessels, membranes) is left untreated or minimally treated.
- tissue with high water content e.g., tumors, liver parenchyma
- tissue with low water content e.g., nerves, vessels, membranes
- ultrasonic aspirators demonstrate inherent tissue selectivity, providing the ability to avoid critical tissue structures from damage. Ultrasonic aspirators are useful for fine dissection of soft and calcified tissues such as liver parenchyma and soft tumors.
- ultrasonic aspirators have limited hemostatic effect and little ability to dissect other tissues, such as connective tissue. As a result, ultrasonic aspirators are often used with other surgical devices, e.g., ultrasonic shears.
- Ultrasonic shears provide good hemostatic effect and are capable of dissecting connective tissue.
- Ultrasonic shears usually include an elongated shaft attached to a handle assembly. The distal end of the elongated shaft may have a blade and clamp mechanism capable of grasping, coagulating, and cutting tissue.
- ultrasonic shears may increase the risk of inadvertently grasping, coagulating, and cutting critical tissue structures.
- surgeons often use both devices, leveraging the strength of each device. For example, in a liver transection, a surgeon may use an ultrasonic aspirator for fine dissection of liver parenchyma and then transition to ultrasonic shears to skeletonize and seal bile ducts. Using several devices during a procedure may be expensive, cumbersome, and increase operation time and complexity.
- an ultrasonic surgical instrument including a handpiece, a lever operably coupled to the handpiece and movable between first, second, and third positions, a shaft assembly extending distally from the handpiece, and an ultrasonic waveguide extending through the shaft assembly and defining a fixed jaw member at a distal portion thereof.
- a movable jaw member may be disposed towards a distal portion of the shaft assembly and operably coupled to the lever such that movement of the lever between the first, second, and third positions moves the movable jaw member relative to the fixed jaw member between a retracted position, wherein the movable jaw member is retracted relative to the fixed jaw member, an extended open position, wherein the movable jaw member opposes and is spaced-apart from the fixed jaw member, and an extended closed position, wherein the movable jaw member opposes and is approximated relative to the fixed jaw member.
- the fixed jaw member defines a first aperture adapted to emit irrigation fluid therefrom.
- the first aperture communicates with a first passageway extending through the waveguide or the shaft assembly to the handpiece.
- the fixed jaw member defines a second aperture for receiving aspirated material from a surgical site.
- the second aperture communicates with a second passageway extending through the waveguide or the shaft assembly to the handpiece.
- an ultrasonic transducer is disposed within the handpiece and operably coupled to the waveguide.
- a dual stage button is disposed on the handpiece and coupled to the ultrasonic transducer for activating the ultrasonic transducer in each of a low power mode and a high power mode.
- a drive assembly is operably coupled between the movable jaw member and the lever such that movement of the lever between the first, second, and third positions moves the movable jaw member relative to the fixed jaw member between the retracted, extended open, and extended closed positions.
- the drive assembly includes an actuation sleeve slidably disposed within the shaft assembly, the actuation sleeve having a proximal end portion operatively connected to the lever and a distal end portion operatively connected to the movable jaw member, wherein movement of the lever translates the actuation sleeve through the shaft assembly to move the movable jaw member relative to the fixed jaw member.
- an upper pin and a lower pin are operably associated with the movable jaw member.
- the shaft assembly defines a dual slot arrangement including an upper slot for receipt of the upper pin, the upper slot having a proximal longitudinal portion and a distal downward sloping portion, and a lower slot for receipt of the lower pin, the lower slot having a proximal longitudinal portion and a distal downward sloping portion.
- the upper and lower pins are disposed at proximal end portions of the proximal longitudinal portions of the respective upper and lower slots.
- the upper pin in the extended open position of the movable jaw member, is disposed at a transition between the proximal longitudinal portion and the distal downward sloping portion of the upper slot, and the lower pin is disposed at a distal end of the distal downward sloping portion of the lower slot.
- the upper and lower pins are disposed at distal end portions of the distal downward sloping portions of the respective upper and lower slots.
- a dial is disposed at a distal end portion of the handpiece and operably coupled to the shaft assembly for selectively rotating the shaft assembly and the end effector assembly relative to the handpiece.
- the handpiece includes a fluid inlet port configured to operably couple to a fluid source.
- the handpiece includes a suction port configured to operably couple to a source of vacuum.
- the movable jaw member includes a clamp pad disposed thereon.
- the clamp pad further includes teeth configured to facilitate grasping tissue between the movable jaw member and the fixed jaw member.
- FIG. 1 is a perspective view of one illustrative embodiment of an ultrasonic surgical instrument provided in accordance with the present disclosure
- FIG. 2 is a side, longitudinal, cross-sectional view of the ultrasonic surgical instrument of FIG. 1 ;
- FIG. 2A is an enlarged, cross-sectional view of the indicated area of detail delineated in FIG. 2 ;
- FIG. 3A is a side, longitudinal, cross-sectional view of a proximal end portion of the ultrasonic surgical instrument of FIG. 1 showing a lever in a distal position “D”;
- FIG. 3B is a side view of an end effector assembly of the ultrasonic surgical instrument of FIG. 1 in a retracted position “R” corresponding to the distal position “D” of the lever;
- FIG. 4A is a side, longitudinal, cross-sectional view of the proximal end portion of the ultrasonic surgical instrument of FIG. 1 showing the lever in a first proximal position “P 1 ”;
- FIG. 4B is a side view of the end effector assembly of the ultrasonic surgical instrument of FIG. 1 in the open position “O” corresponding to the first proximal position “P 1 ” of the lever;
- FIG. 5A is a side, longitudinal, cross-sectional view of the proximal end portion of the ultrasonic surgical instrument of FIG. 1 showing the lever in a second proximal position “P 2 ”;
- FIG. 5B is a side view of the end effector assembly of the ultrasonic surgical instrument of FIG. 1 in a closed position “C” corresponding to the second proximal position “P 2 ” of the lever;
- FIG. 6 is a side view of the drive assembly of the ultrasonic surgical instrument of FIG. 1 .
- the ultrasonic surgical instrument of the present disclosure incorporates the features of ultrasonic aspirators and ultrasonic shears into a single device.
- the device In the ultrasonic aspiration mode, the device allows for fine dissection of tissue, for example, around critical structures.
- the ultrasonic shears mode the device provides the ability to clamp, coagulate, and/or dissect tissue.
- an ultrasonic surgical instrument 10 provided in accordance with the present disclosure generally includes a handpiece 12 , a body assembly 14 ( FIG. 2 ), a dual stage button 15 , a dial 70 , a shaft assembly 75 , an end effector assembly 80 , a lever 90 , and a drive assembly 100 ( FIG. 6 ).
- a handpiece 12 a handpiece 12
- a body assembly 14 FIG. 2
- a dual stage button 15 a dial 70
- shaft assembly 75 a shaft assembly 75
- an end effector assembly 80 a lever 90
- a drive assembly 100 FIG. 6
- handpiece 12 at least partially encloses and supports a body assembly 14 including a transducer 16 , e.g., a piezoelectric stack, a horn 18 , and a waveguide 20 that extends distally from handpiece 12 to end effector assembly 80 .
- a cable 19 electrically couples the transducer 16 to a source of electrical energy (not shown).
- a source of electrical energy not shown
- an O-ring may be placed onto the proximal end of the transducer. Electrical energy provided from the electrical energy source (not shown) is transmitted to electrodes associated with transducer 16 to drive the transducer 16 .
- Transducer 16 converts the electrical energy into mechanical impulses (i.e., ultrasonic waves) which are then transmitted through horn 18 to waveguide 20 .
- Transducer 16 is configured as a piezoelectric stack and may operate at a frequency of between 23 Hz to 55 kHz, although it is also envisioned that any suitable transducer of any frequency may be used.
- the resulting ultrasonic energy transmitted via waveguide 20 to end effector assembly 80 allows end effector assembly 80 to treat tissue.
- Dial 70 is operably coupled to body assembly 14 so as to enable selective rotation of shaft assembly 75 and end effector assembly 80 relative to handpiece 12 .
- Dual stage button 15 may be used to activate ultrasonic surgical instrument 10 in both an ultrasonic aspiration mode “A” ( FIG. 3B ) and an ultrasonic shears mode “B” ( FIGS. 4B and 5 B), as described in further detail below.
- ultrasonic aspiration mode “A” FIG. 3B
- ultrasonic surgical instrument 10 may be activated in a low power mode, which may initiate a tissue selective algorithm, e.g., low suction, low amplitude/frequency, and duty cycling.
- a tissue selective algorithm e.g., low suction, low amplitude/frequency, and duty cycling.
- ultrasonic surgical instrument 10 may transition from the low power mode to a high power mode, corresponding to a debulking algorithm, e.g., high suction, high amplitude, no duty cycling.
- a debulking algorithm e.g., high suction, high amplitude, no duty cycling.
- the first and second depressions of dual stage button 15 may correspond to low and high power modes, respectively.
- ultrasonic energy is emitted from transducer 16 and transmitted along horn 18 and waveguide 20 to a fixed jaw member 83 defined at a distal end portion of waveguide 20 .
- the ultrasonic energy causes fixed jaw member 83 of waveguide 20 to rapidly vibrate such that, when contacted with tissue, enables the treatment of tissue.
- An irrigation and aspiration fluid housing 38 is disposed towards the proximal end portion of handpiece 12 .
- a fluid inlet 42 communicates with an annular fluid line 44 defined between an inner surface of inner tube 76 of shaft assembly 75 and an outer surface of waveguide 20 .
- Fluid line 44 ultimately communicates with an irrigation channel 82 b ( FIG. 3B ) defined through body portion 82 a ( FIG. 3B ) of fixed jaw member 83 .
- irrigation fluid may be urged through fluid inlet 42 , through annular fluid line 44 , through body portion 82 a of fixed jaw member 83 , and out a distal opening 82 c of irrigation channel 82 b , as indicated by arrow “IR” ( FIG. 2A ).
- Irrigation channel 82 b may include a polyimide tube (not shown) extending at least partially therethrough. Further, a flue (not shown) of any suitable shape, size, or material may be placed around distal opening 82 c.
- An aspiration channel 81 b extends longitudinally from a distal opening 81 c defined within body portion 81 a of fixed jaw member 83 to an axial passage 58 defined within waveguide 20 .
- An outlet conduit 62 communicates with axial passage 58 to enable the aspiration of irrigation fluid and emulsified tissue adjacent to end effector assembly 80 .
- Fluid inlet 42 and outlet conduit 62 may be coupled separately to a pump source (not shown) and a vacuum source (not shown), respectively, for enabling irrigation and aspiration, or may be coupled to a combined pump/vacuum source (not shown).
- emulsified tissue and irrigation fluid may be aspirated, e.g., vacuumed or pumped, as indicated by arrow “AS” ( FIG. 2A ), into distal opening 81 c and aspiration channel 81 b through axial passage 58 and out of outlet conduit 62 .
- Shaft assembly 75 extends distally from handpiece 12 and includes end effector assembly 80 ( FIGS. 1-5 ) disposed at a distal end portion thereof.
- Outer tube 77 of shaft assembly 75 defines a slot arrangement 120 ( FIGS. 3B, 4B, 5B ) towards the distal end portion thereof.
- End effector 80 includes fixed jaw member 83 defined at the distal end portion of waveguide 20 and a movable jaw member 84 .
- Movable jaw member 84 includes a body 84 a and two pins 84 b , 84 c operably coupled to body 84 a , which are engagable and/or movable within slot arrangement 120 ( FIGS. 3B-5B ), as detailed below, to manipulate movable jaw member 84 relative to fixed jaw member 83 .
- Movable jaw member 84 defines a jaw member body 84 a and two pins disposed thereon: an upper pin 84 b and a lower pin 84 c .
- Upper pin 84 b and lower pin 84 c in relation to each other, may be configured in a longitudinally offset arrangement.
- Movable jaw member 84 is slidably and pivotably mounted relative to fixed jaw member 83 and shaft assembly 75 via receipt of pins 84 b , 84 c within slot arrangement 120 of shaft assembly 75 .
- the ultrasonic aspiration mode “A” FIGS.
- fixed jaw member 83 in which fixed jaw member 83 is utilized to treat, e.g., dissect, tissue, fixed jaw member 83 may be used in conjunction with movable jaw member 84 in an ultrasonic shears mode “B” ( FIGS. 4A-4B ) to selectively grasp and treat, e.g., coagulate and dissect tissue.
- Movable jaw member 84 may include a clamp pad 85 ( FIG. 4B ) disposed thereon.
- Claim pad 85 may define teeth 86 ( FIG. 4B ) to provide traction against movement of tissue disposed between jaw members 83 , 84 .
- Clamp pad 85 ( FIG. 4B ) may also include tread patterns or other suitable patterns for this purpose, and may be formed from TEFLONTM or the like to reduce friction.
- Fixed jaw member 83 may have a Gaussian cross-sectional profile or other suitable cross-sectional profile to provide the best surface area for distribution of ultrasonic energy and for adequate tissue contact. In addition, the Gaussian cross-sectional profile maximizes displacement with minimal stress.
- Body portion 82 a of fixed jaw member 83 provides a sharp edge, e.g., for the dissection and sealing of tissue.
- lever 90 is disposed on and extends into handpiece 12 .
- Lever 90 is movable between a distal position “D” ( FIG. 3A ), a first proximal position “P 1 ” ( FIG. 4A ), and a second proximal position “P 2 ” ( FIG. 5A ) and is operably connected to drive assembly 100 ( FIG. 6 ).
- Drive assembly 100 includes an actuation shaft 110 that extends between inner tube 76 and outer tube 77 of shaft assembly 75 and is operably coupled to jaw member 84 . As detailed below, movement of lever 90 translates actuation shaft 110 to move movable jaw member 84 .
- movable jaw member 84 to be movable between a retracted position “R” ( FIG. 3B ), an open position “O” ( FIG. 4B ), and/or closed position “C” ( FIG. 5B ) in response to movement of lever 90 .
- movable jaw member 84 is in the retracted position “R” ( FIG. 3B )
- ultrasonic surgical instrument 10 is in the “ultrasonic aspiration mode “A” ( FIGS. 3A and 3B ).
- jaw member 84 is in the open position “O” or closed position “C” ( FIGS.
- ultrasonic surgical instrument 10 is in the ultrasonic shears mode “B” ( FIGS. 4A-5B ) and can be utilized in conjunction with fixed jaw member 83 to enable the selective grasping, coagulation, and dissection of tissue.
- drive assembly 100 generally includes, in addition to actuation shaft 110 , an upper bar 101 , a lower bar 102 , and a cross bar 103 disposed between upper and lower bars 101 , 102 and interconnecting upper and lower bars 101 , 102 .
- a distal end portion 102 a of lower bar 102 is operatively connected to lever 90 while a proximal end portion 102 b of lower bar 102 is operatively connected, e.g., pivotably coupled, to a lower end 103 a of cross bar 103 .
- a proximal end portion 101 b of upper bar 101 is operatively connected, e.g., pivotably coupled, to an upper end 103 b of cross bar 103 , while a distal end portion 101 a of upper bar 101 is operatively connected, e.g., pivotably coupled, to actuation shaft 110 .
- a middle portion 103 c of cross bar 103 is operatively connected, e.g., pivotably coupled, to body assembly 14 .
- Actuation shaft 110 is slidably mounted relative to handpiece 12 and shaft assembly 75 for movement in an axial direction (e.g., distally and proximally).
- Lever 90 extends into and is pivotably coupled within handpiece 12 to enable lever 90 to pivot upon a fixed point within handpiece 12 between the three positions described above (“D,” “P 1 ,” and “P 2 ,” ( FIGS. 3B, 4B, 5B , respectively)). Since lever 90 is operatively connected to drive assembly 100 , which is operatively connected to actuation shaft 110 , movement of lever 90 urges actuation shaft 110 distally or proximally in the axial direction depending on the position of lever 90 . More specifically, pivoting of lever 90 distally urges actuation shaft 110 proximally, while pivoting of lever 90 proximally urges actuation shaft 110 distally. A distal end portion of actuation shaft 110 ( FIG. 2 ) is operatively connected to movable jaw member 84 .
- slot arrangement 120 includes an upper slot 121 and a lower slot 122 defined within outer tube 77 of shaft assembly 75 .
- Upper slot 121 has a longitudinal portion 121 a that transitions into a downward sloping distal portion 121 b .
- Lower slot 122 has a longitudinal portion 122 a that transitions into a downward sloping distal portion 122 b .
- Distal portion 121 b and/or distal portion 122 b may be linear or may define curved configurations.
- Upper pin 84 b of movable jaw member 84 is slidably disposed within upper slot 121
- lower pin 84 c of movable jaw member 84 is slidably disposed within lower slot 122 .
- ultrasonic surgical instrument 10 is shown as a “pencil-style” device, it should be appreciated that ultrasonic surgical instrument 10 could be implemented with a pistol grip or any other suitable configuration. Ultrasonic surgical instrument 10 may also be operatively connected to a computing device (not shown), such that the operation of ultrasonic surgical instrument 10 may be monitored and/or adjusted before or during a procedure. Ultrasonic surgical instrument 10 may also be provided in a battery powered and/or cordless configuration.
- ultrasonic surgical instrument 10 is shown in the ultrasonic aspiration mode “A.”
- the ultrasonic aspiration mode “A” is achieved when lever 90 is moved to a distal most position “D.”
- end effector 80 of ultrasonic surgical instrument 10 may be used, for example, to finely/precisely dissect tissues around critical structures.
- jaw member 84 In ultrasonic aspiration mode “A,” jaw member 84 is in a retracted position “R” such that it does not obstruct the surgeon's view during a procedure or interfere with fine dissection of tissue.
- Suction and/or irrigation are operable in the ultrasonic aspiration mode “A.” For example, irrigation fluid is ejected from distal opening 82 c of irrigation channel 82 b to wash the transection plane and tissue particles from the surgical site such that the surgeon's view remains unobstructed. Additionally, irrigation fluid from distal opening 82 c of irrigation channel 82 b may cool fixed jaw member 83 to prevent burning or charring of tissue. Fluid flowing into and through ultrasonic surgical instrument 10 may also prevent ultrasonic surgical instrument 10 from failure caused by overheating.
- Distal opening 81 c of aspiration channel 81 b may have a substantially teardrop shape to facilitate, e.g., the aspiration and irrigation of tissue.
- upper pin 84 b and lower pin 84 c are disposed at the most proximal ends of upper slot 121 and lower slot 122 , respectively.
- clamp pad 85 of jaw member 84 is not in contact with jaw member 83 as shown by gap “G” ( FIG. 3B ).
- ultrasonic surgical instrument 10 is shown in the ultrasonic shears mode “B.”
- ultrasonic surgical instrument 10 can be used to treat (e.g., coagulate and/or dissect) tissue.
- the ultrasonic shears mode “B” may be achieved when lever 90 is moved from the distal position “D” ( FIG. 3A ) to a first proximal position “P 1 ” ( FIG. 4A ), which causes movable jaw member 84 to extend and pivot from the retracted position “R” ( FIG. 3B ) to the extended, open position “O” ( FIG. 4B ).
- lever 90 is moved from the distal position “D” ( FIG. 3A ) to a first proximal position “P 1 ” ( FIG. 4A ), which causes movable jaw member 84 to extend and pivot from the retracted position “R” ( FIG. 3B ) to the extended, open position “O” ( FIG. 4B ).
- lever 90 In order to move movable jaw member 84 from the retracted position “R” ( FIG. 3B ) to the extended, open position “O” ( FIG. 4B ), as noted above, lever 90 is pivoted proximally from the distal position “D” to the first proximal position “P 1 .” In response to this movement of lever 90 , actuation shaft 110 ( FIGS. 2 and 6 ) is moved distally such that lower pin 84 c of jaw member 84 is moved to the most distal position of distal portion 122 b of lower slot 122 , while upper pin 84 b is moved to the transition point between longitudinal portion 121 a and distal portion 121 b of slot 121 .
- lever 90 is pivoted proximally from the first proximal position “P 1 ” ( FIG. 4A ) to the second proximal position “P 2 ” ( FIG. 5A ).
- actuation shaft 110 FIGS.
- upper pin 84 b and lower pin 84 c of jaw member body 84 a and jaw member 84 are urged distally and through the downwardly sloping distal portions 121 b , 122 b of slots 121 , 122 , causing clamp pad 85 of jaw member 84 to contact and engage with jaw member 83 , thereby eliminating gap “G.”
- a smaller gap be provided in the closed position “C.”
- the travel distance of jaw member 84 between the retracted position “R,” open position “O,” and/or closed position “C” may be relatively small.
- the boomerang-shape-like configuration of cross bar 103 allows for maximum travel of lever 90 , such that the travel of lever 90 from each position (e.g., “D” to “P 1 ” or “D to “P 2 ,” “P 1 ” to “D” or “P 1 ” to “P 2 ,” “P 2 ” to “D” or “P 2 ” to “P 1 ”) is amplified versus the actual travel distance of jaw member 84 , resulting in an appropriate level of tactile feedback.
Abstract
Description
- This application is a continuation application of U.S. patent application Ser. No. 15/428,686, filed on Feb. 9, 2017, the entire contents of which is hereby incorporated herein by reference.
- The present disclosure relates to surgical instruments, and more particularly, to an ultrasonic surgical instrument
- Ultrasonic devices for surgical uses are well known. Ultrasonic devices convert electrical energy into high frequency mechanical impulses (ultrasonic waves) that are then used to treat tissue.
- One type of commonly used ultrasonic surgical device is an ultrasonic aspirator, which typically includes a handpiece, an elongated probe, and a vibrating tip. Ultrasonic waves emanating from the vibrating tip treat tissue with high water content (e.g., tumors, liver parenchyma) while tissue with low water content (e.g., nerves, vessels, membranes) is left untreated or minimally treated. Thus, ultrasonic aspirators demonstrate inherent tissue selectivity, providing the ability to avoid critical tissue structures from damage. Ultrasonic aspirators are useful for fine dissection of soft and calcified tissues such as liver parenchyma and soft tumors. However, ultrasonic aspirators have limited hemostatic effect and little ability to dissect other tissues, such as connective tissue. As a result, ultrasonic aspirators are often used with other surgical devices, e.g., ultrasonic shears.
- Ultrasonic shears provide good hemostatic effect and are capable of dissecting connective tissue. Ultrasonic shears usually include an elongated shaft attached to a handle assembly. The distal end of the elongated shaft may have a blade and clamp mechanism capable of grasping, coagulating, and cutting tissue. However, ultrasonic shears may increase the risk of inadvertently grasping, coagulating, and cutting critical tissue structures. Thus, during certain procedures, surgeons often use both devices, leveraging the strength of each device. For example, in a liver transection, a surgeon may use an ultrasonic aspirator for fine dissection of liver parenchyma and then transition to ultrasonic shears to skeletonize and seal bile ducts. Using several devices during a procedure may be expensive, cumbersome, and increase operation time and complexity.
- Provided in accordance with aspects of the present disclosure is an ultrasonic surgical instrument including a handpiece, a lever operably coupled to the handpiece and movable between first, second, and third positions, a shaft assembly extending distally from the handpiece, and an ultrasonic waveguide extending through the shaft assembly and defining a fixed jaw member at a distal portion thereof. A movable jaw member may be disposed towards a distal portion of the shaft assembly and operably coupled to the lever such that movement of the lever between the first, second, and third positions moves the movable jaw member relative to the fixed jaw member between a retracted position, wherein the movable jaw member is retracted relative to the fixed jaw member, an extended open position, wherein the movable jaw member opposes and is spaced-apart from the fixed jaw member, and an extended closed position, wherein the movable jaw member opposes and is approximated relative to the fixed jaw member.
- In an aspect of the present disclosure, the fixed jaw member defines a first aperture adapted to emit irrigation fluid therefrom.
- In another aspect of the present disclosure, the first aperture communicates with a first passageway extending through the waveguide or the shaft assembly to the handpiece.
- In yet another aspect of the present disclosure, the fixed jaw member defines a second aperture for receiving aspirated material from a surgical site.
- In still another aspect of the present disclosure, the second aperture communicates with a second passageway extending through the waveguide or the shaft assembly to the handpiece.
- In another aspect of the present disclosure, an ultrasonic transducer is disposed within the handpiece and operably coupled to the waveguide.
- In yet another aspect of the present disclosure, a dual stage button is disposed on the handpiece and coupled to the ultrasonic transducer for activating the ultrasonic transducer in each of a low power mode and a high power mode.
- In still another aspect of the present disclosure, a drive assembly is operably coupled between the movable jaw member and the lever such that movement of the lever between the first, second, and third positions moves the movable jaw member relative to the fixed jaw member between the retracted, extended open, and extended closed positions.
- In still yet another aspect of the present disclosure, the drive assembly includes an actuation sleeve slidably disposed within the shaft assembly, the actuation sleeve having a proximal end portion operatively connected to the lever and a distal end portion operatively connected to the movable jaw member, wherein movement of the lever translates the actuation sleeve through the shaft assembly to move the movable jaw member relative to the fixed jaw member.
- In another aspect of the present disclosure, an upper pin and a lower pin are operably associated with the movable jaw member.
- In yet another aspect of the present disclosure, the shaft assembly defines a dual slot arrangement including an upper slot for receipt of the upper pin, the upper slot having a proximal longitudinal portion and a distal downward sloping portion, and a lower slot for receipt of the lower pin, the lower slot having a proximal longitudinal portion and a distal downward sloping portion.
- In still yet another aspect of the present disclosure, in the retracted position of the movable jaw member, the upper and lower pins are disposed at proximal end portions of the proximal longitudinal portions of the respective upper and lower slots.
- In still another aspect of the present disclosure, in the extended open position of the movable jaw member, the upper pin is disposed at a transition between the proximal longitudinal portion and the distal downward sloping portion of the upper slot, and the lower pin is disposed at a distal end of the distal downward sloping portion of the lower slot.
- In another aspect of the present disclosure, in the extended closed position of the movable jaw member, the upper and lower pins are disposed at distal end portions of the distal downward sloping portions of the respective upper and lower slots.
- In yet another aspect of the present disclosure, a dial is disposed at a distal end portion of the handpiece and operably coupled to the shaft assembly for selectively rotating the shaft assembly and the end effector assembly relative to the handpiece.
- In still yet another aspect of the present disclosure, the handpiece includes a fluid inlet port configured to operably couple to a fluid source.
- In still another aspect of the present disclosure, the handpiece includes a suction port configured to operably couple to a source of vacuum.
- In another aspect of the present disclosure, the movable jaw member includes a clamp pad disposed thereon.
- In yet another aspect of the present disclosure, the clamp pad further includes teeth configured to facilitate grasping tissue between the movable jaw member and the fixed jaw member.
- Objects and features of the present disclosure will become apparent to those of ordinary skill in the art when descriptions thereof are read with reference to the accompanying drawings, of which:
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FIG. 1 is a perspective view of one illustrative embodiment of an ultrasonic surgical instrument provided in accordance with the present disclosure; -
FIG. 2 is a side, longitudinal, cross-sectional view of the ultrasonic surgical instrument ofFIG. 1 ; -
FIG. 2A is an enlarged, cross-sectional view of the indicated area of detail delineated inFIG. 2 ; -
FIG. 3A is a side, longitudinal, cross-sectional view of a proximal end portion of the ultrasonic surgical instrument ofFIG. 1 showing a lever in a distal position “D”; -
FIG. 3B is a side view of an end effector assembly of the ultrasonic surgical instrument ofFIG. 1 in a retracted position “R” corresponding to the distal position “D” of the lever; -
FIG. 4A is a side, longitudinal, cross-sectional view of the proximal end portion of the ultrasonic surgical instrument ofFIG. 1 showing the lever in a first proximal position “P1”; -
FIG. 4B is a side view of the end effector assembly of the ultrasonic surgical instrument ofFIG. 1 in the open position “O” corresponding to the first proximal position “P1” of the lever; -
FIG. 5A is a side, longitudinal, cross-sectional view of the proximal end portion of the ultrasonic surgical instrument ofFIG. 1 showing the lever in a second proximal position “P2”; -
FIG. 5B is a side view of the end effector assembly of the ultrasonic surgical instrument ofFIG. 1 in a closed position “C” corresponding to the second proximal position “P2” of the lever; and -
FIG. 6 is a side view of the drive assembly of the ultrasonic surgical instrument ofFIG. 1 . - The ultrasonic surgical instrument of the present disclosure incorporates the features of ultrasonic aspirators and ultrasonic shears into a single device. In the ultrasonic aspiration mode, the device allows for fine dissection of tissue, for example, around critical structures. In the ultrasonic shears mode, the device provides the ability to clamp, coagulate, and/or dissect tissue. These and other aspects and features of the present disclosure are detailed hereinbelow.
- Referring generally to
FIG. 1 , an ultrasonicsurgical instrument 10 provided in accordance with the present disclosure generally includes ahandpiece 12, a body assembly 14 (FIG. 2 ), adual stage button 15, adial 70, ashaft assembly 75, anend effector assembly 80, alever 90, and a drive assembly 100 (FIG. 6 ). Aspects and features of ultrasonicsurgical instrument 10 not germane to the understanding of the present disclosure are omitted to avoid obscuring the aspects and features of the present disclosure in unnecessary detail. - Referring to
FIGS. 1, 2, and 2A ,handpiece 12 at least partially encloses and supports abody assembly 14 including atransducer 16, e.g., a piezoelectric stack, ahorn 18, and awaveguide 20 that extends distally fromhandpiece 12 to endeffector assembly 80. Acable 19 electrically couples thetransducer 16 to a source of electrical energy (not shown). In embodiments, an O-ring (not shown) may be placed onto the proximal end of the transducer. Electrical energy provided from the electrical energy source (not shown) is transmitted to electrodes associated withtransducer 16 to drive thetransducer 16.Transducer 16 converts the electrical energy into mechanical impulses (i.e., ultrasonic waves) which are then transmitted throughhorn 18 towaveguide 20.Transducer 16 is configured as a piezoelectric stack and may operate at a frequency of between 23 Hz to 55 kHz, although it is also envisioned that any suitable transducer of any frequency may be used. As will be described in further detail below (FIGS. 3A-5B ), the resulting ultrasonic energy transmitted viawaveguide 20 to endeffector assembly 80 allowsend effector assembly 80 to treat tissue.Dial 70 is operably coupled tobody assembly 14 so as to enable selective rotation ofshaft assembly 75 andend effector assembly 80 relative tohandpiece 12. -
Dual stage button 15 may be used to activate ultrasonicsurgical instrument 10 in both an ultrasonic aspiration mode “A” (FIG. 3B ) and an ultrasonic shears mode “B” (FIGS. 4B and 5B), as described in further detail below. In the ultrasonic aspiration mode “A” (FIG. 3B ), upon a first depression ofdual stage button 15, ultrasonicsurgical instrument 10 may be activated in a low power mode, which may initiate a tissue selective algorithm, e.g., low suction, low amplitude/frequency, and duty cycling. Upon a second depression ofdual stage button 15 in the ultrasonic aspiration mode “A” (FIG. 3B ), ultrasonicsurgical instrument 10 may transition from the low power mode to a high power mode, corresponding to a debulking algorithm, e.g., high suction, high amplitude, no duty cycling. In the ultrasonic shears mode “B” (FIGS. 4B and 5B ), the first and second depressions ofdual stage button 15 may correspond to low and high power modes, respectively. In either mode, upon depression ofdual stage button 15, ultrasonic energy is emitted fromtransducer 16 and transmitted alonghorn 18 andwaveguide 20 to a fixedjaw member 83 defined at a distal end portion ofwaveguide 20. The ultrasonic energy causes fixedjaw member 83 ofwaveguide 20 to rapidly vibrate such that, when contacted with tissue, enables the treatment of tissue. - An irrigation and aspiration
fluid housing 38 is disposed towards the proximal end portion ofhandpiece 12. Afluid inlet 42 communicates with anannular fluid line 44 defined between an inner surface ofinner tube 76 ofshaft assembly 75 and an outer surface ofwaveguide 20.Fluid line 44 ultimately communicates with anirrigation channel 82 b (FIG. 3B ) defined throughbody portion 82 a (FIG. 3B ) of fixedjaw member 83. Thus, irrigation fluid may be urged throughfluid inlet 42, throughannular fluid line 44, throughbody portion 82 a of fixedjaw member 83, and out adistal opening 82 c ofirrigation channel 82 b, as indicated by arrow “IR” (FIG. 2A ).Outer tube 77 ofshaft assembly 75 surroundsinner tube 76, withactuation shaft 110 of drive assembly 100 (FIGS. 2 and 6 ) disposed therebetween.Irrigation channel 82 b may include a polyimide tube (not shown) extending at least partially therethrough. Further, a flue (not shown) of any suitable shape, size, or material may be placed arounddistal opening 82 c. - An
aspiration channel 81 b extends longitudinally from adistal opening 81 c defined withinbody portion 81 a of fixedjaw member 83 to anaxial passage 58 defined withinwaveguide 20. Anoutlet conduit 62 communicates withaxial passage 58 to enable the aspiration of irrigation fluid and emulsified tissue adjacent to endeffector assembly 80.Fluid inlet 42 andoutlet conduit 62 may be coupled separately to a pump source (not shown) and a vacuum source (not shown), respectively, for enabling irrigation and aspiration, or may be coupled to a combined pump/vacuum source (not shown). Thus, emulsified tissue and irrigation fluid may be aspirated, e.g., vacuumed or pumped, as indicated by arrow “AS” (FIG. 2A ), intodistal opening 81 c andaspiration channel 81 b throughaxial passage 58 and out ofoutlet conduit 62. -
Shaft assembly 75 extends distally fromhandpiece 12 and includes end effector assembly 80 (FIGS. 1-5 ) disposed at a distal end portion thereof.Outer tube 77 ofshaft assembly 75 defines a slot arrangement 120 (FIGS. 3B, 4B, 5B ) towards the distal end portion thereof.End effector 80 includes fixedjaw member 83 defined at the distal end portion ofwaveguide 20 and amovable jaw member 84.Movable jaw member 84 includes abody 84 a and twopins body 84 a, which are engagable and/or movable within slot arrangement 120 (FIGS. 3B-5B ), as detailed below, to manipulatemovable jaw member 84 relative to fixedjaw member 83. -
Movable jaw member 84 defines ajaw member body 84 a and two pins disposed thereon: anupper pin 84 b and alower pin 84 c.Upper pin 84 b andlower pin 84 c, in relation to each other, may be configured in a longitudinally offset arrangement.Movable jaw member 84 is slidably and pivotably mounted relative to fixedjaw member 83 andshaft assembly 75 via receipt ofpins slot arrangement 120 ofshaft assembly 75. As will be described below, in addition to the ultrasonic aspiration mode “A” (FIGS. 3A and 3B ) in which fixedjaw member 83 is utilized to treat, e.g., dissect, tissue, fixedjaw member 83 may be used in conjunction withmovable jaw member 84 in an ultrasonic shears mode “B” (FIGS. 4A-4B ) to selectively grasp and treat, e.g., coagulate and dissect tissue. -
Movable jaw member 84 may include a clamp pad 85 (FIG. 4B ) disposed thereon. Claimpad 85 may define teeth 86 (FIG. 4B ) to provide traction against movement of tissue disposed betweenjaw members FIG. 4B ) may also include tread patterns or other suitable patterns for this purpose, and may be formed from TEFLON™ or the like to reduce friction.Fixed jaw member 83 may have a Gaussian cross-sectional profile or other suitable cross-sectional profile to provide the best surface area for distribution of ultrasonic energy and for adequate tissue contact. In addition, the Gaussian cross-sectional profile maximizes displacement with minimal stress.Body portion 82 a of fixedjaw member 83 provides a sharp edge, e.g., for the dissection and sealing of tissue. - Referring to
FIGS. 1, 2, and 6 ,lever 90 is disposed on and extends intohandpiece 12.Lever 90 is movable between a distal position “D” (FIG. 3A ), a first proximal position “P1” (FIG. 4A ), and a second proximal position “P2” (FIG. 5A ) and is operably connected to drive assembly 100 (FIG. 6 ).Drive assembly 100 includes anactuation shaft 110 that extends betweeninner tube 76 andouter tube 77 ofshaft assembly 75 and is operably coupled tojaw member 84. As detailed below, movement oflever 90 translatesactuation shaft 110 to movemovable jaw member 84. The retention ofpins slot arrangement 120 allowsmovable jaw member 84 to be movable between a retracted position “R” (FIG. 3B ), an open position “O” (FIG. 4B ), and/or closed position “C” (FIG. 5B ) in response to movement oflever 90. Whenmovable jaw member 84 is in the retracted position “R” (FIG. 3B ), ultrasonicsurgical instrument 10 is in the “ultrasonic aspiration mode “A” (FIGS. 3A and 3B ). Whenjaw member 84 is in the open position “O” or closed position “C” (FIGS. 4B and 5B , respectively), ultrasonicsurgical instrument 10 is in the ultrasonic shears mode “B” (FIGS. 4A-5B ) and can be utilized in conjunction with fixedjaw member 83 to enable the selective grasping, coagulation, and dissection of tissue. - With particular reference to
FIG. 6 , drive assembly 100 generally includes, in addition toactuation shaft 110, anupper bar 101, alower bar 102, and across bar 103 disposed between upper andlower bars lower bars lower bar 102 is operatively connected to lever 90 while a proximal end portion 102 b oflower bar 102 is operatively connected, e.g., pivotably coupled, to a lower end 103 a ofcross bar 103. Aproximal end portion 101 b ofupper bar 101 is operatively connected, e.g., pivotably coupled, to anupper end 103 b ofcross bar 103, while adistal end portion 101 a ofupper bar 101 is operatively connected, e.g., pivotably coupled, toactuation shaft 110. Amiddle portion 103 c ofcross bar 103 is operatively connected, e.g., pivotably coupled, tobody assembly 14.Actuation shaft 110 is slidably mounted relative to handpiece 12 andshaft assembly 75 for movement in an axial direction (e.g., distally and proximally). -
Lever 90 extends into and is pivotably coupled withinhandpiece 12 to enablelever 90 to pivot upon a fixed point withinhandpiece 12 between the three positions described above (“D,” “P1,” and “P2,” (FIGS. 3B, 4B, 5B , respectively)). Sincelever 90 is operatively connected to driveassembly 100, which is operatively connected toactuation shaft 110, movement oflever 90 urgesactuation shaft 110 distally or proximally in the axial direction depending on the position oflever 90. More specifically, pivoting oflever 90 distally urgesactuation shaft 110 proximally, while pivoting oflever 90 proximally urgesactuation shaft 110 distally. A distal end portion of actuation shaft 110 (FIG. 2 ) is operatively connected tomovable jaw member 84. - Referring back to
FIGS. 3A-5B ,slot arrangement 120 includes anupper slot 121 and alower slot 122 defined withinouter tube 77 ofshaft assembly 75.Upper slot 121 has alongitudinal portion 121 a that transitions into a downward slopingdistal portion 121 b.Lower slot 122 has alongitudinal portion 122 a that transitions into a downward slopingdistal portion 122 b.Distal portion 121 b and/ordistal portion 122 b may be linear or may define curved configurations.Upper pin 84 b ofmovable jaw member 84 is slidably disposed withinupper slot 121, whilelower pin 84 c ofmovable jaw member 84 is slidably disposed withinlower slot 122. The relative positioning ofpins movable jaw member 84 and the configuration and relative positioning ofslots lever 90 movesmovable jaw member 84 between its three positions, as detailed below. Although ultrasonicsurgical instrument 10 is shown as a “pencil-style” device, it should be appreciated that ultrasonicsurgical instrument 10 could be implemented with a pistol grip or any other suitable configuration. Ultrasonicsurgical instrument 10 may also be operatively connected to a computing device (not shown), such that the operation of ultrasonicsurgical instrument 10 may be monitored and/or adjusted before or during a procedure. Ultrasonicsurgical instrument 10 may also be provided in a battery powered and/or cordless configuration. - Referring now to
FIGS. 3A and 3B , ultrasonicsurgical instrument 10 is shown in the ultrasonic aspiration mode “A.” The ultrasonic aspiration mode “A” is achieved whenlever 90 is moved to a distal most position “D.” In ultrasonic aspiration mode “A,”end effector 80 of ultrasonicsurgical instrument 10 may be used, for example, to finely/precisely dissect tissues around critical structures. - In ultrasonic aspiration mode “A,”
jaw member 84 is in a retracted position “R” such that it does not obstruct the surgeon's view during a procedure or interfere with fine dissection of tissue. Suction and/or irrigation are operable in the ultrasonic aspiration mode “A.” For example, irrigation fluid is ejected fromdistal opening 82 c ofirrigation channel 82 b to wash the transection plane and tissue particles from the surgical site such that the surgeon's view remains unobstructed. Additionally, irrigation fluid fromdistal opening 82 c ofirrigation channel 82 b may cool fixedjaw member 83 to prevent burning or charring of tissue. Fluid flowing into and through ultrasonicsurgical instrument 10 may also prevent ultrasonicsurgical instrument 10 from failure caused by overheating. Likewise, fragmented bits of tissue as well as irrigation fluid and other fluids are aspirated from the surgical site throughdistal opening 81 c ofaspiration channel 81 b.Distal openings - As shown in
FIG. 3B , withmovable jaw member 84 in the retracted position “R,”upper pin 84 b andlower pin 84 c are disposed at the most proximal ends ofupper slot 121 andlower slot 122, respectively. In this retracted position “R,”clamp pad 85 ofjaw member 84 is not in contact withjaw member 83 as shown by gap “G” (FIG. 3B ). - Referring now to
FIGS. 4A and 4B , ultrasonicsurgical instrument 10 is shown in the ultrasonic shears mode “B.” In the ultrasonic shears mode “B,” ultrasonicsurgical instrument 10 can be used to treat (e.g., coagulate and/or dissect) tissue. The ultrasonic shears mode “B” may be achieved whenlever 90 is moved from the distal position “D” (FIG. 3A ) to a first proximal position “P1” (FIG. 4A ), which causesmovable jaw member 84 to extend and pivot from the retracted position “R” (FIG. 3B ) to the extended, open position “O” (FIG. 4B ). As shown inFIG. 5A , further proximal movement oflever 90 causes it to reach its proximal most position, or second proximal position “P2,” which causesjaw member 84 to pivot towardsjaw member 83 into a closed position “C” (FIG. 5B ). Thus, in ultrasonic shears mode “B,” tissue disposed betweenjaw members - In order to move
movable jaw member 84 from the retracted position “R” (FIG. 3B ) to the extended, open position “O” (FIG. 4B ), as noted above,lever 90 is pivoted proximally from the distal position “D” to the first proximal position “P1.” In response to this movement oflever 90, actuation shaft 110 (FIGS. 2 and 6 ) is moved distally such thatlower pin 84 c ofjaw member 84 is moved to the most distal position ofdistal portion 122 b oflower slot 122, whileupper pin 84 b is moved to the transition point betweenlongitudinal portion 121 a anddistal portion 121 b ofslot 121. This movement ofpins slots movable jaw member 84 to move distally and pivot to the extended, open position “O,” wherebylower pin 84 c in the distal most position ofdistal portion 122 b oflower slot 122 acts as a pivot point forjaw member 84. In open position “O,”upper pin 84 b andlower pin 84 c may be longitudinally aligned, as shown inFIG. 4B . - Referring to
FIGS. 5A and 5B , in order to pivotmovable jaw member 84 from the open position “O” (FIG. 4B ) to the closed position “C” (FIG. 5B ), as noted above,lever 90 is pivoted proximally from the first proximal position “P1” (FIG. 4A ) to the second proximal position “P2” (FIG. 5A ). In response to this movement oflever 90, actuation shaft 110 (FIGS. 2 and 6 ) is moved further distally such thatupper pin 84 b andlower pin 84 c ofjaw member 84 are guided into the distal most position ofdistal portion 121 b ofupper slot 121 and the distal most position ofdistal portion 122 b oflower slot 122, respectively. To achieve the closed position “C,”upper pin 84 b andlower pin 84 c ofjaw member body 84 a andjaw member 84 are urged distally and through the downwardly slopingdistal portions slots clamp pad 85 ofjaw member 84 to contact and engage withjaw member 83, thereby eliminating gap “G.” However, it is also contemplated that, rather than entirely eliminating the gap “G,” a smaller gap be provided in the closed position “C.” - The travel distance of
jaw member 84 between the retracted position “R,” open position “O,” and/or closed position “C” may be relatively small. To give a user appropriate tactile feedback between the actuation oflever 90 and the resulting travel ofjaw member 84 withinslot arrangement 120, the boomerang-shape-like configuration ofcross bar 103 allows for maximum travel oflever 90, such that the travel oflever 90 from each position (e.g., “D” to “P1” or “D to “P2,” “P1” to “D” or “P1” to “P2,” “P2” to “D” or “P2” to “P1”) is amplified versus the actual travel distance ofjaw member 84, resulting in an appropriate level of tactile feedback. - It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications, and variances. The embodiments described with reference to the attached drawings are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods, and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.
Claims (20)
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US16/520,064 US20190343549A1 (en) | 2017-02-09 | 2019-07-23 | Ultrasonic surgical instrument |
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US15/428,686 US10368897B2 (en) | 2017-02-09 | 2017-02-09 | Ultrasonic surgical instrument |
US16/520,064 US20190343549A1 (en) | 2017-02-09 | 2019-07-23 | Ultrasonic surgical instrument |
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US15/428,686 Continuation US10368897B2 (en) | 2017-02-09 | 2017-02-09 | Ultrasonic surgical instrument |
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US4063557A (en) | 1976-04-01 | 1977-12-20 | Cavitron Corporation | Ultrasonic aspirator |
US4223676A (en) | 1977-12-19 | 1980-09-23 | Cavitron Corporation | Ultrasonic aspirator |
US4526571A (en) | 1982-10-15 | 1985-07-02 | Cooper Lasersonics, Inc. | Curved ultrasonic surgical aspirator |
US4750488A (en) | 1986-05-19 | 1988-06-14 | Sonomed Technology, Inc. | Vibration apparatus preferably for endoscopic ultrasonic aspirator |
US5176677A (en) | 1989-11-17 | 1993-01-05 | Sonokinetics Group | Endoscopic ultrasonic rotary electro-cauterizing aspirator |
US8348880B2 (en) | 2001-04-04 | 2013-01-08 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument incorporating fluid management |
EP1635718B1 (en) | 2003-06-17 | 2021-02-24 | Ethicon LLC | Hand activated ultrasonic instrument |
US20050192610A1 (en) | 2004-02-27 | 2005-09-01 | Houser Kevin L. | Ultrasonic surgical shears and tissue pad for same |
EP1802245B8 (en) | 2004-10-08 | 2016-09-28 | Ethicon Endo-Surgery, LLC | Ultrasonic surgical instrument |
US7479148B2 (en) | 2004-11-08 | 2009-01-20 | Crescendo Technologies, Llc | Ultrasonic shear with asymmetrical motion |
US20070173872A1 (en) | 2006-01-23 | 2007-07-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument for cutting and coagulating patient tissue |
US8114104B2 (en) | 2006-06-01 | 2012-02-14 | Ethicon Endo-Surgery, Inc. | Mechanism for assembly of ultrasonic instrument |
US20100063525A1 (en) | 2008-09-05 | 2010-03-11 | Jean Michael Beaupre | Ultrasonic shears force limiting |
US8663270B2 (en) * | 2010-07-23 | 2014-03-04 | Conmed Corporation | Jaw movement mechanism and method for a surgical tool |
JP5249471B2 (en) * | 2011-03-01 | 2013-07-31 | オリンパスメディカルシステムズ株式会社 | Ultrasonic probe |
US9549749B2 (en) * | 2012-10-08 | 2017-01-24 | Covidien Lp | Surgical forceps |
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- 2017-02-09 US US15/428,686 patent/US10368897B2/en active Active
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- 2019-07-23 US US16/520,064 patent/US20190343549A1/en not_active Abandoned
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US20180221048A1 (en) | 2018-08-09 |
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