Abstract: Various embodiments are direct to a surgical instrument comprising and end effector, an articulating shaft and an ultrasonic transducer assembly. The end effector may comprise an ultrasonic blade. The articulating shaft may extend proximally from the end effector along a longitudinal axis and may comprise a proximal shaft member and a distal shaft member pivotably coupled at an articulation joint. The ultrasonic transducer assembly may comprise an ultrasonic transducer acoustically coupled to the ultrasonic blade. The ultrasonic transducer assembly may be positioned distally from the articulation joint.

Abstract: A robotically controlled surgical tool comprising including a lockout mechanism is provided. The surgical tool may comprise an instrument mounting portion. The instrument mounting portion includes a housing, a plate, a shaft assembly comprising an end effector, and a coupler to couple the shaft assembly to the instrument mounting portion. The end effector comprises a first jaw member and a second jaw member, the first and second jaw members defining a channel therebetween, and a blade slideably receivable within the channel to cut tissue located between the first and second jaw members. The surgical tool may include an actuation mechanism to actuate the end effector to provide reciprocating movement of the blade within the channel. A lockout mechanism is coupled to the actuation mechanism. The lockout mechanism may selectively enable reciprocating movement of the blade. An interface mechanically and electrically couples the instrument mounting portion to a robotic manipulator.

Abstract: A system for performing an ocular surgical procedure is provided. The system includes a multiple frequency signal source, a configurable tuned output filter connected to the multiple frequency signal source, and a multiple frequency ultrasonic handpiece. The multiple frequency signal source operates at a first frequency and is configured to drive the configurable filter and the multiple frequency ultrasonic handpiece at the first frequency. The multiple frequency signal source operates at a second frequency and is configured to drive the configurable filter and the multiple frequency ultrasonic handpiece at the second frequency, and the design addresses third harmonic frequency issues for the multiple frequency ultrasonic handpiece. Switchable passive components, such as inductors, resistors, and/or capacitors may be employed in the configurable tuned output circuit, or alternately multiple similar circuits may be employed. Alternately, a multi-tap transformer may be provided.

Abstract: Various embodiments are directed to articulatable surgical instruments. Some embodiments comprise an end effector to treat tissue, where the end effector comprises an ultrasonic blade. A hollow shaft may extend proximally from the end effector along a longitudinal axis. A waveguide may extend through the shaft and may be acoustically coupled to the ultrasonic blade. The waveguide may comprise a distally positioned flange positioned within the hollow shaft proximally from the blade and may be held stationary at a first pivot point positioned within the hollow shaft proximally from the flange. A reciprocating wedge may be positioned within the hollow shaft such that distal motion of the wedge pushes the wedge between the flange and the hollow shaft, causing the ultrasonic blade to pivot about the first pivot point in a first direction.

Abstract: Various example embodiments described herein are directed to articulating surgical instruments for treating tissue comprising an end effector and a shaft extending proximally from the end effector along a longitudinal axis. In certain embodiments, the shaft comprises a plurality of transverse spacer members as well as first and second rotatable members extending through at least a portion of the plurality of transverse spacer members. The first and second rotatable members may both be biased away from the longitudinal axis such that their respective directions of bias vary with rotation of the first rotatable member. When the respective directions of bias of the first and second rotatable members oppose one another, the shaft may be substantially straight. When the respective directions of bias of the first and second rotatable members are aligned with one another, the shaft may articulate away from the longitudinal axis in the direction of the alignment.

Abstract: Methods and devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation.

Abstract: A balanced ultrasonic surgical instrument according to the present invention includes an ultrasonic transmission rod which is connected to a blade or end effector by a balance portion, which includes first and second balance asymmetries designed to compensate for the imbalances induced by the blade.

Abstract: Systems, methods and devices for the treatment of tissue are disclosed. A system includes an elongate tube with a distal portion. A treatment element is positioned on the elongate tube distal portion, the treatment element constructed and arranged to treat target tissue. In one embodiment, gastrointestinal tissue is modified for the treatment of diabetes.

Abstract: An ultrasonic horn for use with an ultrasonic surgical hand piece including a resonator comprises a contacting annulus having a plurality of angled lands. The lands are alternated around the annulus such that adjacent lands have opposite angles. As a result of the adjacent angled lands, a shear stress field is developed in contacted tissue due to the promotion of refracted longitudinal ultrasonic waves propagating in different directions at the interface to the coupled tissue. The shear stress field enhances the fragmentation and removal rate of fibrous, elastic, and tenacious tissue. The horn is hollow permitting suction to be applied to the tissue for controlling tissue contact with the lands.

Abstract: An ultrasonic clamp coagulator assembly that is configured to permit selective cutting, coagulation, and fine dissection required in fine and delicate surgical procedures. The assembly includes a clamping mechanism, which is specifically configured to provide for variable tissue clamping forces.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that has an ultrasonic blade that protrudes from an ultrasonic transducer assembly. In some embodiments, the ultrasonic blade coaxially extends through a rotatable tissue cutting blade that is rotatably supported by a housing that supports the ultrasonic transducer assembly. In other embodiments, the ultrasonic blade and the tissue cutting blade are both selectively rotatable relative to the housing. In yet other embodiments, the tissue cutting blade and the ultrasonic blade are supported relative to each other in separate sheaths attached to the housing.

Abstract: Ultrasound catheter devices and methods provide enhanced disruption of blood vessel obstructions. Ultrasound catheter devices generally include an elongate flexible catheter body with one or more lumens, an ultrasound transmission member extending longitudinally through the catheter body lumen and a distal head coupled with the transmission member and positioned adjacent the distal end of the catheter body for disrupting occlusions. Improved features of ultrasound catheters include catheter bodies and ultrasound transmission members with increasing distal flexibility, guidewire tubes allowing contact between a guidewire and an ultrasound transmission member, distal heads with improved guidewire lumens, and torquable proximal housings for enhancing disruption of blood vessel occlusions.

Abstract: An ultrasonic clamp coagulator system that is configured to permit selective cutting, coagulation and clamping of tissue during surgical procedures. An elongated portion of the instrument can be configured for endoscopic applications and has an outside diameter of less than 6 mm. The system includes a one-piece torque wrench that is provided with cantilever arms aligned in an annular fashion about the centerline of the torque wrench. The cantilever arms include teeth in an inward perpendicular fashion in relation to cantilever arms. The clamp coagulator includes an outer tube retainer that includes spline gears projecting in a perpendicular fashion along the outer circumference of retainer. Torque is transmitted through the cantilever arms to the spline gears for attaching a handpiece to the clamp coagulator.

Abstract: An ultrasonic surgical apparatus and method of use including a signal generator outputting a drive signal having a frequency, an oscillating structure, receiving the drive signal and oscillating at the frequency of the drive signal, a bridge circuit, detecting the mechanical motion of the oscillating structure and outputting a signal representative of the mechanical motion, and a microcontroller receiving the signal output by the bridge circuit, the microcontroller determining an instantaneous frequency at which the oscillating structure is oscillating based on the received signal, and comparing the instantaneous frequency to a known frequency value and estimating a temperature of the oscillating structure based on the comparison.

Abstract: An ultrasonic surgical apparatus including a first signal generator outputting a drive signal at a predetermined voltage and frequency, a first oscillating structure receiving the drive signal and oscillating at the frequency of the drive signal, and a bridge circuit, detecting the mechanical motion of the first oscillating structure and outputting a signal representative of the mechanical motion.

Abstract: An ultrasonic surgical apparatus and method, the apparatus including a signal generator outputting a drive signal having a frequency, an oscillating structure, receiving the drive signal and oscillating at the frequency of the drive signal, and a bridge circuit, detecting the mechanical motion of the oscillating structure and outputting a signal representative of the mechanical motion. The ultrasonic surgical apparatus also includes a microcontroller receiving the signal output by the bridge circuit, the microcontroller determining an instantaneous frequency at which the oscillating structure is oscillating based on the received signal, and determining a frequency adjustment necessary to maintain the oscillating structure oscillating at its resonance frequency, the microcontroller further determining the quality (Q value) of the signal received from the bridge circuit and determining material type contacting the oscillating structure.

Abstract: A system, delivery device and method delivers ultrasonic energy to a target musculoskeletal tissue site. In some embodiments, the delivery device includes a stainless steel needle joined to a horn. In some embodiments, the stainless steel needle is joined to the horn using a heating process or a brazing process.

Abstract: In some examples, nerves surrounding arteries or leading to organs are targeted with energy sources to correct or modulate physiologic processes. In some examples, different types of energy sources are utilized singly or combined with one another. In some examples, bioactive agents or devices activated by the energy sources are delivered to the region of interest and the energy is enhanced by such agents or the agents are enhanced by the energy sources.

Abstract: An ultrasonic surgical instrument is provided and includes a housing. A shaft is supported on the housing and defines a longitudinal axis therethrough. The shaft supports a jaw member at a distal end thereof. The jaw member is movable between open and clamping configurations. A probe includes proximal and distal ends. The distal end has an active blade thereon configured to effect tissue when the jaw member is in the clamping configuration. The proximal end has at least one mating feature thereon. A rotating assembly operably supported on the housing is configured to rotate the shaft. The rotating assembly includes a torque adapter that is engageable with the at least one mating feature to selectively and releasably couple the probe to the housing.

Abstract: A surgical tool system including a handpiece with a motor and a cutting accessory with a shaft that is rotated by the handpiece motor. The handpiece includes a coupling assembly with plural locking elements for holding the accessory shaft to an output drive shaft that is actuated by the handpiece motor. The locking elements are longitudinally spaced apart from each other. The accessory shaft is formed with retention features against which the handpiece locking elements engage. The shaft retention features are in columns. The retention features in adjacent retention features are longitudinally offset from each other. This allows the coarse or fine adjustment of the extent to which the accessory shaft extends forward from the handpiece coupling assembly.

Abstract: An ultrasonic surgical instrument including an ultrasonically actuated blade or end effector having a treatment portion. The blade can define a central axis and at least one axis which is transverse to the central axis, wherein the transverse axis can lie within a plane which is perpendicular, or normal, to the longitudinal axis and can define a cross-section of the treatment portion. Such a cross-section can include a central portion and a step extending from the central portion, wherein the central portion can comprise a width, and wherein the step can comprise a cutting edge. In at least one embodiment, the cutting edge can be defined by first and second surfaces which define an angle therebetween. In various embodiments, the position of the cutting edge and/or the angle between the cutting edge surfaces can be selected in order to balance the blade with respect to the transverse axis.

Abstract: A method and system for energy-based (e.g., ultrasound treatment and/or other modalities) of sweat glands are provided. An exemplary method and system for targeted treatment of sweat glands can be configured in various manners, such as through use of therapy only, therapy and monitoring, imaging and therapy, or therapy, imaging, and monitoring, and/or through use of focused, unfocused, or defocused ultrasound (or other energy) through control of various spatial and temporal parameters. As a result, ablative energy can be deposited at the particular depth at which the aberrant sweat gland population is located below the skin surface.

Abstract: A grasping treatment device includes a first sheath section, a second sheath section including a bending cylindrical section, and a rotating transmitting portion configured to rotate to allow a grasping section and the first sheath section to rotate in one of periaxial directions of a longitudinal axis with respect to the second sheath section. The grasping treatment device includes an opening/closing transmitting portion configured to move a movable portion of the first sheath section toward a proximal direction with respect to a probe fixed portion by being pulled toward the proximal direction, and an acting force transmitting portion configured to transmit an acting force from the probe fixed portion to the bending cylindrical section, the acting force being configured to act on the probe fixed portion from the movable portion toward the proximal direction.

Abstract: A method for the treatment of a patient for the purpose of lowering blood pressure and/or treating other medical conditions such as cardiac arrhythmias. A catheter having an ablation element is placed inside the body of a patient and is directed to a targeted location either on in the abdominal aorta where the right or left renal arteries branch from the aorta at or near the superior junction or ostia or on the inside of the inferior vena cava near the junction with the right renal vein or in the left renal vein at a position spatially near where the left renal artery branches from the abdominal aorta. Catheters designed for use in the method where these targeted locations are also disclosed and claimed.

Abstract: In various embodiments, a surgical instrument for operation in an aqueous environment is provided. In at least one embodiment, the surgical instrument may include a hollow sheath, a blade disposed at least partially within the hollow sheath and extending through an opening in the sheath, and at least one ultrasonic transducer operably coupled to the blade. The blade may include a polygonal cross-sectional shape and the tip may project away from the sheath's longitudinal axis. In another embodiment, the surgical instrument may include a blade with suction disposed therethrough and at least one ultrasonic transducer operably coupled to the blade. The blade may include a cutting edge that is positioned over a blade opening. Also, the cutting edge may project away from the blade's longitudinal axis.

Abstract: A torsional ultrasound surgical hand piece lessens or eliminates chatter from lens material by imparting a twisting, rotary motion to a tip of a phacoemulsification needle at a resonant frequency in excess of 32 kHz. The hand piece has a horn that is designed to operate at an elevated frequency while maintaining size constraints for hand-held ophthalmic instruments. Optionally, heat generation is reduced either through the use of a polyimide tubing situated between the needle and the infusion sleeve, through the use of thermal watch to prevent overheating at the incision, and/or through the use of a bypass hole in the needle that diverts flow under suction into the needle via the bypass hole instead of exiting through an irrigation opening in the infusion sleeve when a tip port is occluded by lens material.

Abstract: A surgical instrument including a tool member cover and a cover deployment device are disclosed. The cover is supported adjacent to or on the tool assembly of the surgical instrument and is movable from a first position in which the tool assembly is uncovered to a second position in which the tool assembly is at least partially encompassed by the cover. The deployment device is provided for moving the cover from the first position to the second position.

Abstract: Various forms are directed to a method for operating an ultrasonic surgical instrument. The ultrasonic surgical instrument may be activated by generating a drive signal provided to the ultrasonic drive system to drive the end effector. A plurality of input variables may be applied to a multi-variable model to generate a multi-variable model output, where the multi-variable model output corresponds to an effect of the ultrasonic instrument on tissue. The plurality of input variables may comprise at least one variable describing the drive signal and at least one variable describing a property of the ultrasonic surgical instrument. When the multi-variable model output reaches a threshold value, feedback may be generated indicating a corresponding state of at least one of the ultrasonic surgical instrument and tissue acted upon by the ultrasonic surgical instrument.

Abstract: An ultrasound treatment system comprises an ultrasonic transducer, a handpiece, a probe, a sheath, a clamping member, an operation unit, an operating member, a suction base, and a perfusion base. The ultrasonic transducer generates ultrasonic vibrations. The handpiece has the ultrasonic transducer incorporated therein. The probe is connected to the ultrasonic transducer for transmitting ultrasonic vibrations to a distal member realizing a stationary portion that is a treatment portion for treating a living tissue. The sheath serves as a protecting member for shielding the probe. The clamping member is opposed to the distal member at the distal end of the sheath for clamping a living tissue in cooperation with the distal member. The operation unit is manipulated for clamping a living tissue with the clamping member and distal member or freeing the living tissue therefrom.

Abstract: An ultrasonic clamp coagulator assembly that is configured to permit selective cutting, coagulation and clamping of tissue during surgical procedures. An elongated portion of the instrument can be configured for endoscopic applications and has an outside diameter of less than 6 mm. The construction includes an outer sheath and an ultrasonic waveguide positioned within the outer sheath. The waveguide includes an ultrasonically actuated blade positioned at least partially distal the waveguide. A rigid support is positioned between the outer sheath and the waveguide.

Abstract: A connector module for an ultrasonic surgical instrument includes a housing having a spindle and a coupling rotatably mounted on the spindle. A first conductor is mechanically coupled to the housing. A first link is rotatable relative to the first conductor between a first position and a second position and includes a first contact positioned to electrically contact the first conductor and a second contact electrically coupled to the first contact and positioned to electrically contact an ultrasonic hand piece.

Abstract: The present invention relates to ultrasonic surgical clamping instruments and, more particularly, to a curved clamp arm for use with ultrasonic surgical instruments that have an ultrasonically actuated blade that, in one case, is ultrasonically actuated to have motion in substantially a single plane. The curved clamp arm opens and closes with respect to the blade and also has a plane of curvature that is parallel to the plane of motion of the blade when the clamp arm is in the closed position, and not parallel to the plane of motion of the blade when the clamp arm is in the open position.

Abstract: A surgical apparatus comprises a body, an ultrasonic transducer, a shaft, and an end effector. The ultrasonic transducer is operable to convert electrical power into ultrasonic vibrations. The shaft couples the end effector and the body together. The end effector comprises an ultrasonic blade in acoustic communication with the ultrasonic transducer. The ultrasonic blade includes a recess region having a plurality of recesses. The recess region is tapered such that the cross-sectional area of the recess region decreases along the length of the recess region. The ultrasonic blade is also curved such that a central longitudinal axis of the ultrasonic blade extends along a curved path. A reference circuit is used to account for voltage drops of unknown values during operation of the surgical apparatus.

Abstract: An ultrasound therapy system is provided that can include any number of features. In some embodiments, the custom transducer housings can be manufactured using a rapid-prototyping method to arrange a plurality of single-element, substantially flat transducers to share a common focal point. The rapid-prototyping method can include, for example, fused-deposition modeling, 3D printing, and stereolithography. In some embodiments, the therapy system can include a plurality of transducer modules insertable into the openings of the transducer housing. Each transducer module can include an acoustic lens, a substantially flat, single-element transducer, and a matching layer disposed between the lens and the transducer. Methods of use and manufacture are also described.

Abstract: Apparatuses and methods for the treatment of glaucoma are provided. The instrument uses either cauterization, a laser to ablate, sonic or ultrasonic energy to emulsify, or mechanical cutting of a portion of the trabecular meshwork. The instrument may also be provided with irrigation, aspiration, and a footplate. The footplate is used to enter Schlemm's canal, serves as a guide, and also protects Schlemm's canal.

Abstract: One aspect of the present disclosure relates to a treatment probe comprising an elongated body member and a needle portion. The elongated body member can have a proximal end portion and a distal end portion. The needle portion can be connected to the distal end portion. The needle portion can include at least one electrode and at least one fluid port. The at least one electrode and the at least one fluid port can be configured to deliver electrical energy and a tumescent fluid, respectively, so that superficial tissue planes overlying a target nerve are protected from inadvertent heat damage as a result of application of electrical energy to a target nerve.

Abstract: Various forms are directed to systems and methods for driving an end effector coupled to an ultrasonic drive system of a surgical instrument. A generator may generate at least one electrical signal. The at least one electrical signal may be monitored against a first set of logic conditions. When an ultrasonic impedance of the surgical instrument exceeds a threshold impedance, a resonant frequency of the at least one electrical signal may be stored as a baseline frequency. A first response of the generator may be triggered upon the occurrence of either the first set of logic conditions being met or the resonant frequency of the at least one electrical signal differing from the baseline frequency by a baseline deviation threshold.

Abstract: A surgical device. The surgical device may comprise a transducer, an end effector, a generator and a control circuit. The transducer may be configured to provide vibrations. The end effector may be coupled to the transducer and may extend from the transducer along the longitudinal axis. The generator may provide an electrical signal to the transducer. Also, the control circuit may modify a current amplitude of the electrical signal in response to a change in a vibration frequency of the end effector. Accordingly to various embodiments, the control circuit may detect a first contribution to a vibration frequency of the end effector, the first contribution originating from tissue in contact with the end effector. Also, according to various embodiments, the control circuit may indicate a change in a vibration frequency of the end effector.

Abstract: The present disclosure in some embodiments provides a medical device and to a method of operating the medical device. The medical device, comprising: a monitoring information processor configured to process and display cardiovascular information acquired through diagnosing or monitoring a target area of a patent body; a comparison unit configured to compare at least one values selected from the cardiovascular information with at least one threshold values; a cardiovascular information analysis unit configured to analyze the cardiovascular information provided depending on the result of comparison performed by the comparison unit and to produce an analysis result; and a therapeutic parameter setup unit configured to generate a setup information based on a part or all of the cardiovascular information and the analysis result and to generate therapeutic pulses for adjusting a level of a treatment on the patient body according to the setup information.

Abstract: An apparatus comprises an end effector, a body assembly, a power source, and a control module. The end effector is operable for use in a surgical procedure and can deliver energy to a surgical site. The end effector comprises at least one sensor. The sensor is able to measure at least one physical characteristic associated with the surgical site. The body assembly is in communication with the end effector. The power source is in communication with the body assembly and is operable to deliver power to the end effector. The control module is in communication with the sensor and is operable to change delivery of power to the end effector based on data from the sensor indicating a change in tissue density.

Abstract: A method enabling relatively pain-free wound debridement is provided. The method entails double-delivering ultrasound to the wound and dissecting material to be debrided with a cutting edge. Delivering ultrasound energy via a coupling medium to an area of the wound within the vicinity of the material to be debrided and exposing the material to be debrided to ultrasound vibrations as to induce vibrations about the point of dissection, the double-delivery of ultrasound elicits an effect allowing for relatively pain-free debridement. While the effect elicited by the double-delivery is in place, the material to be debrided is dissected with a cutting edge.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that comprises a handpiece housing that operably supports an electrical contact assembly therein that is in electrical communication with a signal source. An acoustic assembly is supported within the handpiece housing in rotatable contact with the electrical contact assembly. In various embodiments, the signal source produces at least one of an ultrasonic signal and a radio frequency signal.

Abstract: A non-invasive ultra-high frequency ultrasound treatment method and system are provided. An exemplary method and system comprise a high-frequency ultrasound transducer system configured for providing ultrasound treatment to a patient such that the superficial and/or subcutaneous regions of the patient can be treated. An exemplary high-frequency ultrasound transducer system comprises a control system and a transducer configured to provide treatment to the superficial and/or subcutaneous regions of interest. The high-frequency ultrasound transducer may be configured to operate at higher frequencies and controlled power levels to provide treatment to the superficial and/or subcutaneous regions of interest. For example, higher frequencies within the range from approximately 20 MHz to 500 MHz or more may be utilized.

Abstract: Switch assemblies for handheld ultrasonic surgical instruments. The switch assemblies may include a first switch arrangement that is operably supported on a forward portion of a handle housing of the surgical instrument and is selectively movable relative to at least one first switch contact. The switch assembles may further include a second switch arrangement that comprises at least one of a right switch button that is movably supported on a right side of the handle housing relative to at least one right contact and a left switch button that is movably supported on a left side of the handle housing that is selectively movable relative to at least one left contact.

Abstract: An ablation system for treating atrial fibrillation in a patient comprises an elongate shaft having proximal and distal ends, a lumen therebetween and a housing adjacent the distal end of the elongate shaft. An energy source is coupled to the housing and is adapted to deliver energy to a target tissue so as to create a zone of ablation in the target tissue that blocks abnormal electrical activity thereby reducing or eliminating the atrial fibrillation in the patient. A sensor is adjacent the energy source and adapted to detect relative position of the energy source to the target tissue or characteristics of the target tissue. The system also has a reflecting element operably coupled with the energy source and adapted to redirect energy emitted from the energy source in a desired direction or pattern.

Abstract: A surgical instrument including a tool member cover and a cover deployment device are disclosed. The cover is supported adjacent to or on the tool assembly of the surgical instrument and is movable from a first position in which the tool assembly is uncovered to a second position in which the tool assembly is at least partially encompassed by the cover. The deployment device is provided for moving the cover from the first position to the second position.

Abstract: Techniques, apparatus and systems that use an optical probe head to deliver light to a target and to collect light from the target for imaging and monitoring a target while a separate radiation is applied to treat the target.

Abstract: A system for performing an ocular surgical procedure is provided. The system includes a multiple frequency signal source, a configurable tuned output filter connected to the multiple frequency signal source, and a multiple frequency ultrasonic handpiece. The multiple frequency signal source operates at a first frequency and is configured to drive the configurable filter and the multiple frequency ultrasonic handpiece at the first frequency. The multiple frequency signal source operates at a second frequency and is configured to drive the configurable filter and the multiple frequency ultrasonic handpiece at the second frequency, and the design addresses third harmonic frequency issues for the multiple frequency ultrasonic handpiece. Switchable passive components, such as inductors, resistors, and/or capacitors may be employed in the configurable tuned output circuit, or alternately multiple similar circuits may be employed. Alternately, a multi-tap transformer may be provided.

Abstract: Various embodiments are directed to an apparatus and method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument. The method comprises generating at least one electrical signal. The at least one electrical signal is monitored against a first set of logic conditions.

Abstract: An ultrasonic surgical shears includes an ultrasonic surgical blade, a clamping arm operable to open and close toward the blade, and a tissue pad attached to the clamping arm. A method for sealing a blood vessel of a patient includes obtaining an ultrasonic surgical shears and positioning the blood vessel between the blade and the tissue pad. The clamping arm is operated to exert an average coaptation pressure on the blood vessel between and including 60 psi and 210 psi. The blade is ultrasonically vibrated to transect and seal the blood vessel.