ALIGNMENT FEATURES FOR ULTRASONIC SURGICAL INSTRUMENT
An ultrasonic instrument comprises a body, a shaft assembly, an ultrasonic blade, and a pivoting member. The shaft assembly extends distally from the body. The ultrasonic blade is positioned distal to the shaft assembly. The pivoting member is pivotable with respect to the blade from an open position to a closed position to thereby clamp tissue between the pivoting member and the blade. One or both of the shaft assembly or the pivoting member comprise a guide feature. The guide feature is configured to provide lateral alignment of the distal portion of the pivoting member with the blade as the pivoting member is pivoted to the closed position.
A variety of surgical instruments include an end effector having a blade element that vibrates at ultrasonic frequencies to cut and/or seal tissue (e.g., by denaturing proteins in tissue cells). These instruments include one or more piezoelectric elements that convert electrical power into ultrasonic vibrations, which are communicated along an acoustic waveguide to the blade element. The precision of cutting and coagulation may be controlled by the surgeon's technique and adjusting the power level, blade edge angle, tissue traction, and blade pressure.
Examples of ultrasonic surgical instruments include the HARMONIC ACE® Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades, all by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Further examples of such devices and related concepts are disclosed in U.S. Pat. No. 5,322,055, entitled “Clamp Coagulator/Cutting System for Ultrasonic Surgical Instruments,” issued Jun. 21, 1994, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 5,873,873, entitled “Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism,” issued Feb. 23, 1999, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 5,980,510, entitled “Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Arm Pivot Mount,” filed Oct. 10, 1997, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 6,325,811, entitled “Blades with Functional Balance Asymmetries for use with Ultrasonic Surgical Instruments,” issued Dec. 4, 2001, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 6,773,444, entitled “Blades with Functional Balance Asymmetries for Use with Ultrasonic Surgical Instruments,” issued Aug. 10, 2004, the disclosure of which is incorporated by reference herein; and U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument,” issued Aug. 31, 2004, the disclosure of which is incorporated by reference herein.
Still further examples of ultrasonic surgical instruments are disclosed in U.S. Pub. No. 2006/0079874, entitled “Tissue Pad for Use with an Ultrasonic Surgical Instrument,” published Apr. 13, 2006, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2007/0191713, entitled “Ultrasonic Device for Cutting and Coagulating,” published Aug. 16, 2007, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2007/0282333, entitled “Ultrasonic Waveguide and Blade,” published Dec. 6, 2007, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2008/0200940, entitled “Ultrasonic Device for Cutting and Coagulating,” published Aug. 21, 2008, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2009/0105750, entitled “Ergonomic Surgical Instruments,” published Apr. 23, 2009, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2010/0069940, entitled “Ultrasonic Device for Fingertip Control,” published Mar. 18, 2010, the disclosure of which is incorporated by reference herein; and U.S. Pub. No. 2011/0015660, entitled “Rotating Transducer Mount for Ultrasonic Surgical Instruments,” published Jan. 20, 2011, the disclosure of which is incorporated by reference herein; and U.S. Pub. No. 2012/0029546, entitled “Ultrasonic Surgical Instrument Blades,” published Feb. 2, 2012, the disclosure of which is incorporated by reference herein.
Some ultrasonic surgical instruments may include a cordless transducer such as that disclosed in U.S. Pub. No. 2012/0112687, entitled “Recharge System for Medical Devices,” published May 10, 2012, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2012/0116265, entitled “Surgical Instrument with Charging Devices,” published May 10, 2012, the disclosure of which is incorporated by reference herein; and/or U.S. Pat. App. No. 61/410,603, filed Nov. 5, 2010, entitled “Energy-Based Surgical Instruments,” the disclosure of which is incorporated by reference herein.
Additionally, some ultrasonic surgical instruments may include an articulating shaft section. Examples of such ultrasonic surgical instruments are disclosed in U.S. patent application Ser. No. 13/538,588, filed Jun. 29, 2012, entitled “Surgical Instruments with Articulating Shafts,” the disclosure of which is incorporated by reference herein; and U.S. patent application Ser. No. 13/657,553, filed Oct. 22, 2012, entitled “Flexible Harmonic Waveguides/Blades for Surgical Instruments,” the disclosure of which is incorporated by reference herein.
Some ultrasonic surgical instruments may include a clamp feature to press tissue against the ultrasonic blade of the end effector. Examples of such an arrangement (sometimes referred to as a clamp coagulator shears or an ultrasonic transector) is disclosed in U.S. Pat. No. 5,322,055, entitled “Clamp Coagulator/Cutting System for Ultrasonic Surgical Instruments,” issued Jun. 21, 1994, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 5,873,873, entitled “Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism,” issued Feb. 23, 1999, the disclosure of which is incorporated by reference herein; and U.S. Pat. No. 6,325,811, entitled “Blades with Functional Balance Asymmetries for use with Ultrasonic Surgical Instruments,” issue Dec. 4, 2001, the disclosure of which is incorporated by reference herein. Some versions of clamp coagulator shears utilize handles that are either of a pistol or scissors grips design. The scissor grip designs may have one thumb or finger grip that is immovable and fixed to the housing; and one movable thumb or finger grip. Some designs have scissor arms that extend from the grips, with one of the arms rotating around a fixed pivot or rotation point that is perpendicular to the longitudinal axis of the working element. The operator may thus squeeze a handgrip or other feature to drive a clamp arm, to thereby press the clamp pad toward the blade.
While several surgical instruments and systems have been made and used, it is believed that no one prior to the inventors has made or used the invention described in the appended claims.
While the specification concludes with claims which particularly point out and distinctly claim this technology, it is believed this technology will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which:
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present technology, and together with the description serve to explain the principles of the technology; it being understood, however, that this technology is not limited to the precise arrangements shown.
DETAILED DESCRIPTIONThe following description of certain examples of the technology should not be used to limit its scope. Other examples, features, aspects, embodiments, and advantages of the technology will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the technology. As will be realized, the technology described herein is capable of other different and obvious aspects, all without departing from the technology. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
It is further understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. that are described herein. The following-described teachings, expressions, embodiments, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
For clarity of disclosure, the terms “proximal” and “distal” are defined herein relative to a surgeon or other operator grasping a surgical instrument having a distal surgical end effector. The term “proximal” refers the position of an element closer to the surgeon or other operator and the term “distal” refers to the position of an element closer to the surgical end effector of the surgical instrument and further away from the surgeon or other operator.
I. Exemplary Ultrasonic Surgical Instrument
To the extent that there is some degree of overlap between the teachings of the references cited herein, the HARMONIC ACE® Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and/or the HARMONIC SYNERGY® Ultrasonic Blades, and the following teachings relating to instrument (10), there is no intent for any of the description herein to be presumed as admitted prior art. Several teachings herein will in fact go beyond the scope of the teachings of the references cited herein and the HARMONIC ACE® Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades.
Instrument (10) of the present example comprises a handpiece (20), a shaft assembly (30), and an end effector (40). Handpiece (20) comprises a body (22) including a finger grip (24) and a pair of buttons (26). Instrument (10) also includes a clamp arm assembly (50) that is pivotable toward and away from body (22). A proximal portion of clamp arm assembly (50) comprises a thumb grip (52). Thumb grip (52) and finger grip (24) together provide a scissor grip type of configuration. It should be understood, however, that various other suitable configurations may be used, including but not limited to a pistol grip configuration. End effector (40) includes an ultrasonic blade (42) extending distally from shaft assembly (30); and a pivoting clamp arm (54), which is an integral feature of clamp arm assembly (50). Clamp arm assembly (50) is pivotably coupled to a projection (34) extending laterally from shaft assembly (30) via a pivot member (36) (e.g., a pin, bearing, shaft, etc.)=such that clamp arm (54) is pivotable toward and away from ultrasonic blade (42) to thereby clamp tissue between a clamp pad (55) of clamp arm (54) and ultrasonic blade (42). As best seen in
Clamp arm assembly (50) is configured such that clamp arm (54) is pivotable toward ultrasonic blade (42) in response to pivoting of thumb grip (52) of clamp arm assembly (50) toward body (22); and such that clamp arm (54) is pivotable away from ultrasonic blade (42) in response to pivoting of thumb grip (52) of clamp arm assembly (50) away from body (22). As best seen in
As shown in
Ultrasonic vibrations that are generated by transducer assembly (12) are communicated along an acoustic waveguide (80), which extends through shaft assembly (30) to reach ultrasonic blade (42) as shown in
In the present example, the distal end of ultrasonic blade (42) is located at a position corresponding to an anti-node associated with resonant ultrasonic vibrations communicated through waveguide (80), in order to tune the acoustic assembly to a preferred resonant frequency fo when the acoustic assembly is not loaded by tissue. When transducer assembly (12) is energized, the distal end of ultrasonic blade (42) is configured to move longitudinally in the range of, for example, approximately 10 to 500 microns peak-to-peak, and in some instances in the range of about 20 to about 200 microns at a predetermined vibratory frequency fo of, for example, 55.5 kHz. When transducer assembly (12) of the present example is activated, these mechanical oscillations are transmitted through the waveguide to reach ultrasonic blade (42), thereby providing oscillation of ultrasonic blade (42) at the resonant ultrasonic frequency. Thus, when tissue is secured between ultrasonic blade (42) and clamp arm (54), the ultrasonic oscillation of ultrasonic blade (42) may simultaneously sever the tissue and denature the proteins in adjacent tissue cells, thereby providing a coagulative effect with relatively little thermal spread. In some versions, an electrical current may also be provided through ultrasonic blade (42) and clamp arm (54) to also cauterize the tissue. While some configurations for an acoustic transmission assembly and transducer assembly (12) have been described, still other suitable configurations for an acoustic transmission assembly and transducer assembly (12) will be apparent to one or ordinary skill in the art in view of the teachings herein. Similarly, other suitable configurations for end effector (40) will be apparent to those of ordinary skill in the art in view of the teachings herein.
An operator may activate buttons (26) to selectively close switches (27) (see
The foregoing components and operabilities of instrument (10) are merely illustrative. Instrument (10) may be configured in numerous other ways as will be apparent to those of ordinary skill in the art in view of the teachings herein. By way of example only, at least part of instrument (10) may be constructed and/or operable in accordance with at least some of the teachings of any of the following, the disclosures of which are all incorporated by reference herein: U.S. Pat. No. 5,322,055; U.S. Pat. No. 5,873,873; U.S. Pat. No. 5,980,510; U.S. Pat. No. 6,325,811; U.S. Pat. No. 6,783,524; U.S. Pub. No. 2006/0079874; U.S. Pub. No. 2007/0191713; U.S. Pub. No. 2007/0282333; U.S. Pub. No. 2008/0200940; U.S. Pub. No. 2010/0069940; U.S. Pub. No. 2011/0015660; U.S. Pub. No. 2012/0112687; U.S. Pub. No. 2012/0116265; U.S. patent application Ser. No. 13/538,588; and/or U.S. patent application Ser. No. 13/657,553. Additional merely illustrative variations for instrument (10) will be described in greater detail below. It should be understood that the below described variations may be readily applied to instrument (10) described above and any of the instruments referred to in any of the references that are cited herein, among others.
II. Exemplary Clamp Arm Alignment Features
It may be desirable to provide features that guide clamp arm (54) such that clamp arm (54) and/or clamp pad (55) adequately and appropriately engage ultrasonic blade (42) as clamp arm (54) is pivoted toward ultrasonic blade (42). In particular, it may be desirable to ensure that the center (width-wise) of clamp pad (55) is aligned with the center (width-wise) of ultrasonic blade (42) along a common vertical plane as clamp arm (54) is pivoted toward ultrasonic blade (42). An example of such alignment is shown in
A. First Exemplary Guide Feature
The recess in shaft assembly (30) may be tapered (e.g., with tapered lateral walls) such that as clamp arm (54) is pivoted further toward ultrasonic blade (42), and as guide feature (100) is driven further into the recess, the interior shape of the recess more closely resembles that of guide feature (100) thus guiding clamp arm (54) into an intended position. Alternatively, guide feature (100) may be tapered such that as clamp arm (54) is pivoted further toward ultrasonic blade (42), and as guide feature (100) is driven further into the recess, the exterior shape of guide feature (100) more closely resembles that of the recess thus guiding clamp arm (54) into an intended position.
B. Second Exemplary Guide Feature
Recess (112) may be tapered (e.g., with tapered lateral walls) such that as clamp arm (54) is pivoted further toward ultrasonic blade (42), and as guide feature (110) is driven further into recess (112), the interior shape of recess (112) more closely resembles that of guide feature (110) thus guiding clamp arm (54) into an intended position. Alternatively, guide feature (110) may be tapered such that as clamp arm (54) is pivoted further toward ultrasonic blade (42), and as guide feature (110) is driven further into recess (112), the exterior shape of guide feature (100) more closely resembles that of recess (112) thus guiding clamp arm (54) into an intended position.
Guide feature (120) shown in
Guide feature (130) shown in
Guide feature (140) shown in
It should be understood that any of the guide features (120, 130, 140) discussed above may be extend from clamp arm (54) toward an opposing surface of shaft assembly (30), much like guide feature (100) discussed above. It should further be understood that any of the guide features (100, 110, 120, 130, 140) discussed above may be used in combination with one another and may extend from either clamp arm (54), shaft assembly (30), or both. While the guide features (100, 110, 120, 130, 140) discussed above extend into recesses formed in either clamp arm (54) or shaft assembly (30), alternative guide features may instead be configured to engage the lateral outer surfaces of clamp arm (54) or shaft assembly (30).
C. Third Exemplary Guide Feature
It should be understood that with set screws (202, 204) positioned within the threaded bores of first member (53A) and second member (53B), each flat surface (208) of set screws (202, 204) may be substantially flush with or recessed relative to the exterior surfaces of first member (53A) and second member (53B), to avoid inadvertent snagging, tearing, or ripping of tissue during operation.
D. Fourth Exemplary Guide Feature
It should be understood that wave springs (312, 314) may have any stiffness to thereby exert more or less pressure on the exterior surface of shaft assembly (30). Furthermore, it should be understood that wave springs (312, 314) may each have a different stiffness to thereby manipulate the alignment of clamp arm (54) and clamp pad (55) relative to ultrasonic blade (42). As clamp arm (54) is pivoted toward and away from ultrasonic blade (42), wave springs (312, 314) will bear against the exterior surface of shaft assembly (30) in an arcuate pattern.
It should be understood that Belleville washers (322, 324) may have any stiffness to thereby exert more or less pressure on the exterior surface of shaft assembly (30). Furthermore, it should be understood that Belleville washers (322, 324) may each have a different stiffness to thereby manipulate the alignment of clamp arm (54) and clamp pad (55) relative to ultrasonic blade (42). As clamp arm (54) is pivoted toward and away from ultrasonic blade (42), Belleville washers (322, 324) will bear against the exterior surface of shaft assembly (30) along an arcuate path. In some variations, a ball bearing is interposed between each Belleville washer (322, 324) and shaft assembly (30) to reduce friction. It should be understood that ball bearings may be used in a similar fashion with any of the other resilient members referred to herein as slidably bearing against shaft assembly (30).
E. Fifth Exemplary Guide Feature
With clamp arm (54) in the open position as shown in
It should be understood that although interior surfaces (406, 408) of arcuate ramps (402, 404) of the present example have substantially similar angular inclines, interior surfaces (406, 408) of arcuate ramp (402, 404) may have different angular inclines to thereby manipulate the alignment of clamp arm (54) and clamp pad (55) relative to ultrasonic blade (42). Furthermore, it should be understood that although interior surfaces (406, 408) of arcuate ramps (402, 404) of the present example incline in a generally linear fashion, interior surfaces (406, 408) of arcuate ramps (402, 404) may incline at a variable rate. For instance, interior surfaces (406, 408) may be curved along a plane that extends through both surfaces (406, 408). It should also be understood that ramps (402, 404) may be rigid, semi-rigid, elastomeric, and/or have any other suitable properties.
F. Sixth Exemplary Guide Feature
Although not depicted in the present example of guide feature (500), shaft assembly (30) may comprise recesses or spherical indentations configured to receive ball bearings (506, 508). These recesses or indentations may be sized such that ball bearings (506, 508) will not slide within the recesses or indentations, but will instead only roll within these recesses or indentations such that as clamp arm (54) is pivoted toward and away from ultrasonic blade (42), these recesses or indentations will cause ball bearings (506, 508) to slide within arcuate recesses (502, 504).
It should be understood that the size of the ball bearings may be changed to thereby exert more or less pressure on the exterior surface of shaft assembly (30). It should also be understood that although ball bearings (506, 508) of the present example have substantially similar angular sizes, ball bearings (506, 508) may instead have different sizes to thereby manipulate the alignment of clamp arm (54) and clamp pad (55) relative to ultrasonic blade (42).
Furthermore, it should be understood that interior surfaces of arcuate recesses (502, 504) may be inclined such that the interior surface of each arcuate recess (502, 504) transitions from a wider or deeper distal portion to a narrower or shallower proximal portion. With clamp arm (54) in the open position, ball bearings (506, 508) would engage the wider/deeper distal portion of each arcuate recess (502, 504). As clamp arm (54) is pivoted toward ultrasonic blade (42), ball bearings (506, 508) would roll within arcuate recesses (502, 504) such that in the closed position, ball bearings (506, 508) engage the narrow/shallow proximal portion of each arcuate recess (502, 504) to thereby guide clamp arm (54) and clamp pad (55).
G. Seventh Exemplary Guide Feature
In some versions, the interior width of slots (606, 608) and/or the exterior width of projections (602, 604) is inclined such that as clamp arm (54) is pivoted toward ultrasonic blade (42), projections (602, 604) more tightly fit within slots (606, 608) to thereby guide clamp arm (54) and clamp pad (55) as clamp arm (54) is pivoted toward ultrasonic blade (42). In other words, the walls of slots (606, 608) may bear against projections (602, 604) with progressively increasing force as clamp arm (54) is pivoted toward ultrasonic blade (42).
H. Eighth Exemplary Guide Feature
As best seen in
III. Exemplary Waveguide Alignment Features
While the examples described above relate to providing adequate lateral and rotational alignment of clamp arm (54) relative to ultrasonic blade (42), it should be understood that it may be desirable to provide other forms of component alignment within instrument (10), to further address the relative positioning of blade (42) and clamp arm (54). For instance, it may be desirable to ensure that ultrasonic blade (42) is oriented at an appropriate angle about the longitudinal axis of ultrasonic blade (42), relative to clamp arm (54) and handpiece (20). This may be particularly so when ultrasonic blade (42) has an asymmetric cross-sectional profile. Referring back to
In view of the foregoing, it may be desirable to provide features that allow an operator or assembler to rotate and selectively “lock” blade (42) during assembly of instrument (10) such that ultrasonic blade (42) is oriented at an appropriate angle about the longitudinal axis of ultrasonic blade (42), relative to clamp arm (54) and handpiece (20). Several merely illustrative examples of such alignment features are described in detail below, while other examples will be apparent to those of ordinary skill in the art in view of the teachings herein.
A. First Exemplary Waveguide Alignment Feature
During assembly of instrument (10), with locking members (720, 722) in the open position, an operator or assembler may rotate waveguide (702) such that a surface (44) that is perpendicular to the curvature of blade (42) is adequately aligned with the top surface of clamp pad (55), such that upper edge (45) of groove (43) is diametrically opposed to clamp pad (55), or such that any other suitable orientation of blade (42) is achieved. With blade (42) held at a desired angular orientation, locking members (720, 722) may be secured in the closed position to thereby “lock” waveguide (702), and thus blade (42), in position. By way of example only, locking members (720, 722) may be secured in place using welding, adhesive, snap fitting, clamps, clips, rings, and/or any other suitable components/techniques.
While locking members (720, 722) of the present example comprise a plurality of teeth (724, 726), it should be understood that any number of teeth may be used. For instance, teeth (724, 726) may comprise a single tooth. Furthermore, other suitable configurations may be used instead of teeth (724, 726), including but not limited to complementary hex features, etc. It should also be understood that although two locking members (720, 722) are used in the present example, any number of locking members (720, 722) may be used.
B. Second Exemplary Waveguide Alignment Feature
As shown in
C. Third Exemplary Alternative Waveguide Alignment Feature
Alignment feature (760) of this example comprises an exemplary alternative shaft assembly (762). Shaft assembly (762) comprises a proximal member (762A) and a distal member (762B). A proximal portion of distal member (762B) is rotatably disposed within a distal recess (764) of proximal member (762A) such that distal member (762B) may be rotated within proximal member (762A). Proximal member (762A) and distal member (762B) each present an interior bore through which waveguide (80) is disposed. A rotatable ring (768) is disposed within an annular recess (770) formed within an interior surface of proximal member (762A) such that ring (768) is rotatable relative to proximal member (762A). Waveguide (80) is secured to ring (768) via a pin (766) that passes through waveguide (80) and into ring (768). Waveguide (80) and ring (768) are thus configured to rotate unitarily. Pin (766) is located at a position along the length of waveguide (80) corresponding to a node associated with resonant ultrasonic vibrations communicated through waveguide (80).
As shown in
IV. Exemplary Clamp Arm Stiffness Adjustment Feature
It may be desirable to provide features that allow an operator to adjust a stiffness of clamp arm assembly (50). In addition or in the alternative, it may be desirable to provide a first stiffness when clamp arm assembly (50) is pivoted toward shaft assembly (30) and a second stiffness when clamp arm assembly (50) is pivoted away from shaft assembly (30). Merely exemplary stiffening features (800) that provide such varying stiffness are shown in
Clamp arm (802) comprises an integral stiffening rod (806), which extends proximally from a proximal portion of clamp arm (802) and parallel to arm shank (810). A ring (820) is slidably disposed about rod (806) and arm shank (810) such that ring (820) is slidable between a proximal portion (806A) of rod (806) (as shown in
Arm shank (810) of the present example is formed of a semi-rigid material (e.g., plastic), whereas rod (806) is formed of a more rigid material (e.g., metal). As shown in
In some operations, it may be desirable to use instrument (10) to pry tissue apart using a blunt dissection technique. In such operations, an operator may use an outer surface of blade (42) and an outer surface of clamp arm (802) to pry tissue apart, such as by spreading rings (24, 52) apart. As shown in
V. Exemplary Cutting Members
As noted above, end effector (40) may be used to sever tissue using a combination of compression (between clamp pad (55) and ultrasonic blade (42)) and ultrasonic vibrations from blade (42). It may be desirable to provide additional tissue severing capability, such as with a shearing blade that is offset from blade (42) and clamp arm (54).
As best seen in
In an open position as shown in
VI. Miscellaneous
It should be understood that any of the versions of instruments described herein may include various other features in addition to or in lieu of those described above. By way of example only, any of the instruments described herein may also include one or more of the various features disclosed in any of the various references that are incorporated by reference herein. It should also be understood that the teachings herein may be readily applied to any of the instruments described in any of the other references cited herein, such that the teachings herein may be readily combined with the teachings of any of the references cited herein in numerous ways. Other types of instruments into which the teachings herein may be incorporated will be apparent to those of ordinary skill in the art.
It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in robotic-assisted medical treatments and procedures. By way of example only, various teachings herein may be readily incorporated into a robotic surgical system such as the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif. Similarly, those of ordinary skill in the art will recognize that various teachings herein may be readily combined with various teachings of U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004, the disclosure of which is incorporated by reference herein.
Versions described above may be designed to be disposed of after a single use, or they can be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, some versions of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, some versions of the device may be reassembled for subsequent use either at a reconditioning facility, or by a user immediately prior to a procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
By way of example only, versions described herein may be sterilized before and/or after a procedure. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in the sterile container for later use. A device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.
Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.
Claims
I/We claim:
1. An ultrasonic instrument comprising:
- (a) a body;
- (b) a shaft assembly extending distally from the body;
- (c) an ultrasonic blade positioned distal to the shaft assembly; and
- (d) a pivoting member, wherein the pivoting member is pivotably coupled with the shaft assembly, wherein the pivoting member defines a distal portion and a proximal portion, wherein the pivoting member is pivotable with respect to the blade from an open position to a closed position to thereby clamp tissue between the pivoting member and the blade;
- wherein one or both of the pivoting member or the shaft assembly comprise a guide feature configured to provide lateral alignment of the distal portion of the pivoting member with the blade as the pivoting member is pivoted to the closed position.
2. The ultrasonic instrument of claim 1, wherein the guide feature comprises at least one projection extending transversely from one or both of the pivoting member or the shaft assembly.
3. The ultrasonic instrument of claim 2, wherein guide feature further comprises a pocket formed in the other of the pivoting member or the shaft assembly, wherein the pocket is configured to receive the at least one projection when the the pivoting member is in the closed position.
4. The ultrasonic instrument of claim 2, wherein the at least one projection is tapered.
5. The ultrasonic instrument of claim 2, wherein the at least one projection comprises a pair of projections, wherein the pair of projections extend in transversely opposing directions in relation to a longitudinal axis defined by the shaft assembly.
6. The ultrasonic instrument of claim 1, wherein the guide feature comprises at least one set screw, wherein the at least one set screw is configured to bear against an exterior surface of the shaft assembly.
7. The ultrasonic instrument of claim 1, wherein the guide feature comprises at least one resilient member, wherein the at least one resilient member is configured to bear against an exterior surface of the shaft assembly.
8. The ultrasonic instrument of claim 1, wherein the guide feature comprises at least one ramp, wherein the at least one ramp is configured to exert a progressively increasing force upon the exterior surface of the shaft assembly as the pivoting member is pivoted to the closed position.
9. The ultrasonic instrument of claim 1, wherein the guide feature comprises at least one ball bearing configured to bear against an exterior surface of the shaft assembly.
10. The ultrasonic instrument of claim 1, further comprising a cutting member, wherein the cutting member is pivotably coupled with the shaft assembly, wherein the cutting member is further pivotable relative to the pivoting member, wherein the cutting member is configured to slice tissue.
11. The ultrasonic instrument of claim 1, wherein the distal portion of the pivoting member comprises a clamp arm, wherein the pivoting member is pivotable with respect to the blade from an open position to a closed position to thereby clamp tissue between the clamp arm and the blade, wherein the blade has a first transverse height, wherein the clamp arm has a second transverse height, wherein the ratio of the first height to the second height is between approximately 0.8 and approximately 1.0.
12. The ultrasonic instrument of claim 1, wherein the distal portion of the pivoting member comprises a clamp arm, wherein the pivoting member is pivotable with respect to the blade from an open position to a closed position to thereby clamp tissue between the clamp arm and the blade, wherein the clamp arm has a transverse height of less than approximately 0.07 inches.
13. The ultrasonic instrument of claim 1, wherein the distal portion of the pivoting member comprises a clamp arm, wherein the pivoting member is pivotable with respect to the blade from an open position to a closed position to thereby clamp tissue between the clamp arm and the blade, wherein the blade has a first transverse width, wherein the clamp arm has a second transverse width, wherein the ratio of the first height to the second height is between approximately 0.65 and approximately 1.0.
14. The ultrasonic instrument of claim 1, wherein the distal portion of the pivoting member comprises a clamp arm, wherein the pivoting member is pivotable with respect to the blade from an open position to a closed position to thereby clamp tissue between the clamp arm and the blade, wherein the clamp arm has a transverse width of less than approximately 0.065 inches.
15. The ultrasonic instrument of claim 1, further comprising:
- (a) a waveguide extending longitudinally through the shaft assembly, wherein the ultrasonic blade is acoustically coupled with the waveguide; and
- (b) a locking feature, wherein the locking feature is operable to move from an open position to a closed position, wherein the waveguide is operable to rotate within the body when the locking feature is in the open position, and wherein the locking feature is operable to lock the waveguide in a selected rotational position relative to the body when the locking feature is in the closed position.
16. The ultrasonic instrument of claim 1, further comprising a waveguide extending longitudinally through the shaft assembly, wherein the ultrasonic blade is acoustically coupled with the waveguide, wherein the shaft assembly further comprises a distal shaft component and a proximal shaft component, wherein the proximal shaft component is rotatable relative to the distal shaft component to adjust the rotational position of the waveguide relative to the body, wherein the proximal shaft component is securable to the distal shaft component to lock the rotational position of the waveguide relative to the body.
17. The ultrasonic instrument of claim 1, further comprising:
- (a) a waveguide extending longitudinally through the shaft assembly, wherein the ultrasonic blade is acoustically coupled with the waveguide; and
- (b) an annular member secured to a nodal region of the waveguide, wherein the annular member is rotatable relative to the body to adjust the rotational position of the waveguide relative to the body, wherein the annular member is further securable relatively to the body to lock the rotational position of the waveguide relative to the body.
18. An ultrasonic instrument comprising:
- (a) a body;
- (b) a shaft assembly extending distally from the body, wherein the shaft assembly defines a longitudinal axis;
- (c) an ultrasonic blade positioned distal to the shaft assembly; and
- (d) a pivoting member, wherein the pivoting member is pivotably coupled with the shaft assembly, wherein the pivoting member is pivotable along a first plane aligned with the longitudinal axis of the shaft assembly to thereby clamp tissue between the pivoting member and the blade; and
- (e) a resilient member configured to resiliently bias the pivoting member along a second plane aligned with the longitudinal axis of the shaft assembly, wherein the second plane is perpendicular to the first plane.
19. An ultrasonic instrument comprising:
- (a) a body;
- (b) a shaft assembly extending distally from the body;
- (c) a first working element positioned at the distal end of the shaft assembly;
- (d) a pivoting member, wherein the pivoting member is pivotably coupled with the shaft assembly, wherein at least a portion of the pivoting member is deformable;
- (e) a second working element positioned at the distal end of the pivoting member, wherein the pivoting member is pivotable in a first direction to drive the second working element toward the first working element, wherein the pivoting member is pivotable in a second direction to drive the second working element away from the first working element; and
- (f) a stiffening feature, wherein the stiffening feature is configured to provide variable stiffness to the deformable portion of the pivoting member, wherein the stiffening feature is configured to provide a first stiffness to the pivoting member when the pivoting member is pivoted in the first direction, wherein the stiffening feature is configured to provide a second stiffness to the pivoting member when the pivoting member is pivoted in the second direction, wherein the second stiffness is greater than the first stiffness.
20. The ultrasonic instrument of claim 19, wherein the stiffening feature comprises a sliding member slidably disposed along the pivoting member, wherein the sliding member is configured to vary the stiffness of the pivoting member based on a selected longitudinal position of the sliding member relative to the pivoting member.
Type: Application
Filed: Sep 19, 2013
Publication Date: Mar 19, 2015
Inventors: John B. Schulte (West Chester, OH), Craig N. Faller (Milford, OH), Eric B. Smith (Cincinnati, OH), Patrick J. Scoggins (Loveland, OH), JoAnn M. Stegeman (Cincinnati, OH), Tylor C. Muhlenkamp (Cincinnati, OH), William D. Dannaher (Cincinnati, OH), Michael R. Lamping (Cincinnati, OH), Jacob S. Gee (Cincinnati, OH), William B. Weisenburgh, II (Maineville, OH)
Application Number: 14/031,665
International Classification: A61B 17/32 (20060101);